Indications of Pedicled Flaps for Traumatic Soft-Tissue Defects in the Acute Phase

Abstract

Introduction: The purpose of this study was to review cases in which pedicled flap transfer was performed for traumatic soft-tissue defects in the acute phase and to discuss the indications of the pedicled flaps.
Patients and Methods: Nineteen cases (15 males and 4 females, mean age 52.3 years) of pedicled flap transfer were investigated to assess the flap survival rate, early additional surgery, and deep infection. In addition, we compared groups with and without complex injuries.
Results: Fourteen flaps survived and partial necrosis occurred in 5. The survival rate was 73.7%. There were 3 cases in which the necrotic area was further expanded after flap surgery. Six cases required additional surgery in the early phase (5 additional flaps and 1 amputation) . Deep infection developed in 4 cases, 3 of which required early additional surgery. Early additional surgery was required in 6 of 10 cases in the complex injury group and 0 of 9 cases in the no complex injury group, with a significant difference.
Conclusion: For severe open fractures with complex injuries, more reliable soft tissue reconstruction is required. When a pedicled flap is selected, the effects of trauma on the pedicle, the site of the defect, and the extent of the defect should be carefully considered.