title: Soft tissue coverage at the resource-challenged facility.
abstract: Covering soft tissue defects remains challenging for orthopaedic surgeons, especially those in resource-challenged facilities. Covering tissue defects follow a plan from simple to complex: primary closure, local flap, area flap, pedicle flap, and free flap. I will limit my discussion to the role of latter two. At the district-level hospital in Vietnam, pedicle flaps are generally more useful, so I will discuss free flaps only briefly. The choices of pedicle flaps include: kite flap, posterior interosseous flap, radial flap (Chinese flap), neurocutaneous flap, anterolateral thigh fasciocutaneous flap, gastrocnemius flap, sural flap, posterior leg flaps; we typically use a free flap with the latissimus dorsi. Soft tissue coverage with pedicle flaps has many advantages: reliability, relatively easy harvest, and good blood supply. Free flaps with microanastomosis have an important place in covering difficult medium- or large-sized soft tissue defects but also require more instruments and more highly trained surgeons.
authors.affiliation: Department of Plastic and Cosmetic Surgery, University Medical Center, 215 Hong Bang St., 5th District, Ho Chi Minh City, Vietnam. tuana@hcm.vnn.vn
authors.forename: Tuan Anh
authors.initials: TA
authors.lastname: Nguyen
mesh_terms: D017048:Health Care Costs; D015276:Health Care Rationing; D006297:Health Services Accessibility / Q000191:economics; D054625:Healthcare Disparities / Q000191:economics; D006767:Hospitals, District / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D019651:Plastic Surgery Procedures / Q000191:economics; D017695:Soft Tissue Injuries / Q000191:economics / Q000473:pathology / Q000601:surgery*; D013518:Surgery, Plastic / Q000191:economics / Q000458:organization & administration; D013524:Surgical Flaps / Q000191:economics; D016896:Treatment Outcome; D014744:Vietnam