Outcome of islanded gastrocnemius musculocutaneous flap in orthopaedic practice
Introduction: Large wounds in the leg require combination of local flaps or free flap for wound coverage. Gastrocnemius musculocutaneous flap (GMCF) allows a large wound to be covered by a single local flap. However, the conventional GMCF is often associated with donor site morbidity where the...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English English English |
| Published: |
Malaysian Orthopaedic Association
2019
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/71542/1/71542_Outcome%20of%20Islanded%20Gastrocnemius.pdf http://irep.iium.edu.my/71542/7/71542_Outcome%20of%20islanded%20gastrocnemius_SCOPUS.pdf http://irep.iium.edu.my/71542/8/71542_Outcome%20of%20islanded%20gastrocnemius_WOS.pdf http://irep.iium.edu.my/71542/ http://www.morthoj.org/2019/v13n1/islanded-gastrocnemius.pdf http://dx.doi.org/10.5704/MOJ.1903.004 |
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| Summary: | Introduction: Large wounds in the leg require combination
of local flaps or free flap for wound coverage.
Gastrocnemius musculocutaneous flap (GMCF) allows a
large wound to be covered by a single local flap. However,
the conventional GMCF is often associated with donor site
morbidity where the exposed soleus raphe causes poor
uptake of the skin graft. Islanding the skin on the muscles
allows the donor site to be closed primarily, thus avoiding the
donor site morbidity.
Materials and Methods: Medical records of twelve patients
who underwent islanded GMCF surgery from 2004 till 2018
were reviewed retrospectively.
Results: The mean age was 31 years old. Eight cases were
with open fracture of the tibia, two degloving injury
exposing the patella, one open fracture of patella and
necrotising soft tissue infection. The wound size ranged from
12cm2 to 120cm2. All flaps survived. Three patients required
skin grafting at the donor site while in the rest the donor sites
were able to be closed primarily. Four patients developed
deep infection, one healed after vacuum dressing, one after
bone transport and one after split thickness skin graft. One
patient ended up with below knee amputation after
developing chronic osteomyelitis of the tibia.
Conclusion: Islanded gastrocnemius musculocutaneous flap
is an effective simple alternative for coverage of large soft
tissue defects from the knee to half of the leg distally with
minimal donor site morbidity. Aggressive debridement of
unhealthy tissue is necessary to prevent infection following
wound coverage with this flap. |
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