title: The use of microvascular free skin-muscle flaps in management of avulsion injuries of the lower leg.
abstract: The authors used microvascular free skin-muscle flaps to cover avulsion wounds in the lower leg of ten patients. There were three children and seven adults, ranging in age from 5 to 54 years. Vessels supplying gracilis (four) and tensor fascia lata (six) skin-muscle units were anastomosed to the anterior tibial (nine) and posterior tibial (one) vessels. The tensor fascia lata unit has a more constant anatomy and is preferred. Principles of management include: 1) early adequate, but conservative, debridement; 2) continuous bony stabilization; 3) preoperative arteriography; 4) anticoagulation; 5) recipient vessel identification in healthy uninjured tissue; 6) appropriate timing; 7) delayed bone grafting.
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005206:Fascia Lata / Q000637:transplantation; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008875:Middle Aged; D009132:Muscles / Q000098:blood supply / Q000637:transplantation*; D012867:Skin / Q000098:blood supply; D016038:Skin Transplantation; D013518:Surgery, Plastic / Q000379:methods; D014182:Transplantation, Autologous