Shahid Hameed, Muhammad Asif, Tahir Masood, Ayesha Shaukat, Mamoon Rashid, Muhammad Aslam, Amir Riaz Bhutta, Aftab A Choudhri.
Use of the Rectus Abdominis free Flap for Lower Limb Defects.
J Coll Physicians Surg Pak Jan ;10(11):424-9.

Soft tissue defects of the lower extremity, as a result of high energy trauma, are difficult to reconstruct. Injury leads to wide soft tissue destruction and the resultant defect after the debridement usually has exposed bones, tendons and joints which are not easy to resurface with conventional technique. They require microvascular free tissue transfer for the reconstruction. Fasciocutaneous and local muscle flaps are either not available or not suitable for reconstruction. Rectus abdominis muscle free flap is a good choice for soft tissue reconstruction of the lower extremity defects. A total of sixteen patients underwent rectus abdominis free flap reconstruction for soft tissue coverage of the leg over the period of four years. Fifteen were males and one was female. Vehicular trauma was the major cause of defect along with gunshot wounds and mine blast injuries. Ten of these had defect of distal third of the leg while three had involvement of the middle third. Two patients had involvement of heel and the ankle while one had defect over the dorsum of the foot. All were Gustillo type-III injuries. All the patients, who had free rectus abdominis muscle flap, did well and flaps survived completely. Two patients had to be re-explored for venous thrombosis. The results are comparable to other centres.

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