Bipedicled flap in reconstruction of exposed tibia.

Abstract

To evaluate the feasibility of using the bipedicled flap in the reconstruction of an exposed tibia. Twenty-three patients underwent reconstruction of the exposed tibia using the fasciocutaneous bipedicled flap from the medial of the leg (in 12 patients), from the lateral aspect (in 9 patients) and from both the medial and the lateral (in 2 patients). In all cases, the donor site of the flap was covered by split-thickness skin graft. In 23 patients, 25 fasciocutaneous bipedicled flaps were used, a single flap in 21 patients, and double flaps in two patients. Twenty-three flaps were completely viable and healed totally. One of the remaining flaps (which were used to cover an exposed tibia after excision of a chronic leg ulcer) was complicated by partial necrosis due to superficial necrosis of its lateral edge which healed conservatively. The last flap was severely infected resulting in necrosis which required debridement and reconstruction using a free forearm flap. The bipedicled flap has advantages of dual blood supply, achievement of sensitivity in the damaged area and acceptable aesthetic appearance.