ROTATION FASCIOCUTANEOUS FLAP REPAIR OF LOWER-LIMB DEFECTS

The rotation design was applied to fasciocutaneous flap repair of lowe r limb defects to produce a functional and aesthetic result superior t o that obtained by the transposition design. A prospective, consecutiv e series of 21 patients is reported, 14 males and 7 females, ranging i n age from 17 to 81 years (mean 43 years). The primary defects, 8 trau matic, 12 cutaneous malignancy excisions, and 1 radionecrotic ulcer, r anged in size from 3.5 X 3 cm to 10 x 8 cm (mean 6.6 x 5 cm). The rota tion fasciocutaneous flap base ranged from 5 to 25 cm (mean 12 cm), an d the radius ranged from 4.5 to 20 cm (mean 9 cm). The inclusion of a back-cut at the flap base permitted direct donor-site closure in all b ut one patient, obviating the need for a split-thickness skin graft an d avoiding the otherwise inevitable significant contour defect. Postop erative bed rest ranged from 3 to 7 days (mean 5 days). Three minor an d no major complications occurred, and there was complete survival of all flaps. The results in this series indicate a role for the rotation fasciocutaneous flap in the management of traumatic and excisional de fects in the lower limb. It is has proved reliable, gives good aesthet ic results, and reduces treatment costs.