Novel fasciocutaneous flaps for the reconstruction of complicated lower extremity wounds

Summary: Reconstruction of the leg is particularly challenging especiallywhen the defect involves its lower third. The options for lowerleg reconstruction are very few because of the lack of local soft tissueavailable for transfer. Novel fasciocutaneous flaps nourished by perforatorvessels have been developed and are increasingly used as avaluable local alternative to the local flaps, with their high complicationrates, and to the microsurgical flaps, with their more difficult andspecialized technique. They provide local tissue, replacing like withlike, but they harvest it from a distant, undamaged, region of the leg,which means healthy and well-vascularized tissue. They do not needmicrosurgical facilities and skills, which may not be available everywhere.However, it is vital that the vessels are handled with great careand meticulous attention to detail in their preparation for the rotation.The known anatomic exiting sites of the perforator from the fascialplane will guide the planning of the flap, aided by the Dopplerultrasound and an exploratory incision. the surgical technique of perforatorflaps harvesting and flap design, complications and solutions will bediscussed here. Fasciocutaneous perforator flaps can be used as an elegantalternative to other local or free flaps to treat the loss of tissues of the leg,once risk, benefits and expected results are understood.