Archives of Plastic Surgery

  • 제48권4호
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  • Pages.417-426
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  • 2021
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Evaluation of pedicled flaps for type IIIB open fractures of the tibia at a tertiary care center

  • Vathulya, Madhubari (Department of Plastic Surgery, All India Institute of Medical Sciences) ;
  • Dhingra, Mohit (Department of Orthopedics, All India Institute of Medical Sciences) ;
  • Nongdamba, Hawaibam (Department of Orthopedics, All India Institute of Medical Sciences) ;
  • Chattopadhyay, Debarati (Department of Plastic Surgery, All India Institute of Medical Sciences) ;
  • Kapoor, Akshay (Department of Plastic Surgery, All India Institute of Medical Sciences) ;
  • Dhingra, Vandana Kumar (Department of Nuclear Medicine, All India Institute of Medical Sciences) ;
  • Mago, Vishal (Department of Plastic Surgery, All India Institute of Medical Sciences) ;
  • Kandwal, Pankaj (Department of Orthopedics, All India Institute of Medical Sciences)
  • 투고 : 2020.10.22
  • 심사 : 2021.05.27
  • 발행 : 2021.07.15
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초록

Background Soft tissue coverage plays a vital role in replacing the vascularity of the underlying bone in Gustilo type IIIB fractures. The aim of this article was to evaluate the feasibility of local pedicled flaps in type IIIB fractures at a tertiary care center. Methods We included all cases of open Gustilo-Anderson type IIIB fractures of the tibia treated with local flap coverage from January 2017 to February 2019. We carried out a retrospective analysis to investigate the relationships of complications, hospital stay, and cost-effectiveness with the choice of flap, infective foci, site and size of the defect, and type of fixation. Results Out of 138 Gustilo type IIIB fractures analyzed in our study, 27 cases had complications, of which 19 (13.76%) involved flap necrosis, four (2.89%) were infections, three (2.17%) involved partial necrosis, and one (0.72%) was related to bone spur development. Flap complications showed a statistically significant association with the perforator flap category (propeller flaps in particular) (P=0.001). Flap necrosis showed a significant positive correlation with cases treated within 3 weeks after trauma (P=0.046). A significant positive correlation was also found between defect size and the duration of hospital stay (P=0.03). Conclusions Although local flaps are harvested from the same leg that underwent trauma, their success rate is at least as high as microvascular flaps as reported from other centers. Amidst the local flaps, complications were predominantly associated with perforator flaps.

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참고문헌

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