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What are the flaps used for lower extremity wound coverage?

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Asked by Green DP 

a. Thigh 
  • Local muscle flap
b. Proximal 1/3 leg 
  • Medial: Medial gastrocnemius rotational flap (supplied by medial branch of sural artery)
  • Lateral: Lateral gastrocnemius rotational flap (supplied by lateral branch of sural artery)
c. Middle 1/3 leg 
  • Soleus flap (supplied by perforating branches of psoterior tibial and peroneal arteries) 
d. Distal 1/3 leg 
  • Fasciocutaneous perforator flaps or free flaps (gracilis, latissimus dorsi, or rectus abdominis)
e. Ankle 
  • Free flap (reverse sural flap)

Source: AlMugaren FM, Pak CJ, Suh HP, Hong JP. Best Local Flaps for Lower Extremity Reconstruction. Plast Reconstr Surg Glob Open. 2020 Apr 30;8(4):e2774. doi: 10.1097/GOX.0000000000002774. PMID: 32440438; PMCID: PMC7209892.


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