THE ROLE OF LOCAL FASCIAL FLAPS AS AN ADJUNCT TO FREE FLAPS

Local fascial flaps independently are a versatile option, reliable whe n properly designed, and technically simple to execute especially when compared to microsurgical tissue transfers. Although free flaps conti nue to be the method of choice to repair major distal extremity defect s, for smaller wounds it could he preferable to use a local fascial fl ap instead. In reviewing the 194 local fascial/fasciocutaneous flaps u sed by us since 1982, 46 were specifically used in lieu of a free flap that had been initially considered. Only two of these tailed to achie ve their objective, indeed then requiring salvage by a free flap. in a ddition, a local fascial flap was concurrently advantageous as a secon d flap on 17 occasions to simplify coverage of the microanastomoses, t o facilitate closure of the free flap donor site, or as the backup met hod for a failed free flap with limb preservation. Therefore, 32.5% (6 3 of 194) of all of our local fascial flaps were either used as a subs titute for or improved the overall success rate as an integral part of our microsurgical experience during this same time period.