J reconstr Microsurg 2017; 33(S 01): S27-S33
DOI: 10.1055/s-0037-1606559
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Muscle versus Fasciocutaneous Flap in Lower Limb Reconstruction: Is There a Best Option?

Mario Cherubino
1  Division of Plastic and Reconstructive Surgery, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
,
Martina Corno
1  Division of Plastic and Reconstructive Surgery, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
,
Salvatore D'Arpa
2  Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Gent, Belgium
3  Division of Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
,
Pietro Di Summa
4  Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
,
Igor Pellegatta
1  Division of Plastic and Reconstructive Surgery, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
,
Luigi Valdatta
1  Division of Plastic and Reconstructive Surgery, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
,
Mario Ronga
5  Department of Medicine and Health Sciences “Vincenzo Tiberio,” University of Molise, Campobasso, Italy
› Author Affiliations
Further Information

Publication History

19 June 2017

02 August 2017

Publication Date:
06 October 2017 (online)

Abstract

Soft tissue defects of the lower extremity that expose underlying bones, joints, and tendons pose challenging problems and generally require free tissue transfer for a successful reconstruction. Historically, muscle flaps were the gold standard choice for lower limb reconstruction. To obviate the unpredictable appearance and high donor-site morbidity of muscle flaps, fasciocutaneous flaps were introduced. Recently, perforator flaps, such as the anterolateral thigh flap, gained a leading role in the reconstructive scenario. There is growing evidence in the literature supporting that fasciocutaneous and perforator flaps are comparable to muscle flaps in terms of flap survival, postoperative infection, osteomyelitis, bone union, and ambulation. With the advances of knowledge in perforator anatomy and their mapping, a new era of lower limb reconstruction has begun. Propeller flap could be raised on any suitable perforator vessel and, without the aid of microsurgical anastomosis, used to restore small- to middle-sized soft tissue defects. In this review, we intend to analyze pros and cons of muscle and fasciocutaneous free flaps and the applicability of the propeller flaps in lower limb reconstruction.