Abstract

The large soft tissue defect in the lower leg and its treatment remain a challenge. The most suitably available type of tissue, the surgery timing, and the decision between free flap or local for the coverage still remain the subject of debate. One hundred and four patients were managed with a free flap or local cover for a lower leg soft-tissue defect. We compared the outcomes after treatment with free flaps versus local and musculocutaneous flaps versus fasciocutaneous flaps. In this study, we also compared the results of our patients according to the timing of the surgery: patients managed within 3 days after the trauma versus patients managed after 3 days. Thirty-four patients (32.69%) were presented with chronic osteomyelitis and treated accordingly. Seventy patients (67.30%) with posttraumatic soft-tissue defects have been treated because of insufficient fracture coverage. The statistically significant difference in complications was not observed in free and local flaps in our study. Postoperatively. In our study group, patients managed with a musculocutaneous flap were associated with less postoperative complications than fasciocutaneous. In the number of revisions after treatment with a free flap, a significant increase could be demonstrated in the results after early or late flap coverage. There was no significant difference observed. Equal outcomes were observed in patients treated with free flaps or local flaps except local flaps, which required a lesser number of revisions postoperatively. Regarding postoperative complications, Musculocutaneous flaps are preferable over fasciocutaneous flaps. The operation timing is not to be proved a discriminating factor.

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