Coverage of pretibial leg defects with a combination of geometry of random pattern flaps in a diabetic ischaemic leg - Is it possible to have no secondary donor site defects?

Abstract

Coverage of leg defects with exposed bone, with long fasciocutaneous flaps, will almost always lead to the creation of secondary donor site, which requires to be covered with a skin graft harvested from the thigh, creating another wound, which will take 2–3 weeks to heal. Hence, to close and heal a defect, another wound is created, which is a liability for the patient, as there is no certainty that this created wound would heal without any complications. It would be ideal to cover pretibial defects with a flap without the creation of secondary donor site, as done in face and areas having good laxity of the skin. As there is no laxity of skin in a scarred, operated, ischaemic and diabetic leg, performing a flap without the creation of secondary donor site is very challenging.

Keywords

• combined random pattern flap
• pretibial defect
• secondary donor site
• skin graft