The types of repair performed were divided into seven main groups: secondary healing, primary closure, skin graft, local flap
, auricular composite graft, subtotal reconstruction, and prosthesis application.
By gathering these kinds of flaps, it is also possible to negatively influence the postoperative evolution by developing a more or less transitory edema or hematomas, which may compromise the local flap
vascularity by inducing vasospasm, stretching the subdermal plexus, or separating the flap from the surface of the recipient site.
Finally, it is a local flap
that does not need a microsurgical anastomosis but needs microsurgical experience.
2) For middle third defects the Soleus muscle is often used as a local flap
When possible, a local flap
is probably the most convenient reconstructive technique.
After leakage was stopped and the cavity was filled, a secondary suture or a local flap
was used to cover the wound.
An alternative local flap
for coverage of soft tissue defects of the Achilles region is the bipedicled fasciocutaneous flap, which has two major advantages, that is, good vascularity and minimal tension.
The preferred surgical procedure is excision and primary closure either directly or with the help of a local flap
. This method produces a good cosmetic result but has been suggested to have a higher risk of recurrence when compared with healing by secondary intention, although the disadvantage of the latter is a prolonged recovery.
The advantages of this are as follows: it allows restoration of the anatomic contour of the foot, is relatively quick and easy to raise with a two team approach (one team debriding the area and preparing recipient vessels and a second team raising the flap), can cover a defect larger than a local flap
such as medial plantar artery instep flap, is pliable and less bulky than other fasciocutaneous flaps, and is also sensate hence providing protection to the foot.
The beneficial effect of NO on tissue flap health has been demonstrated in a number of local flap
Keystone flap is a relatively simple local flap
, which provides suitable cover to the axilla after excision of hidradenitis suppurativa and facilitates normal range of shoulder movement after surgery.
This led to a wide use of autogenous grafts like dermis fat, subcutaneous fat, auricular cartilage, and temporalis muscle and fascia.19 Out of the different autogenous materials,temporalis muscle has proved to be a reliable muscle flap with predictable blood supply.9,10 Moreover it is a local flap
associated with less surgical morbidity and thus less hospital stay.12,13 Kaban et al used it as a favoured lining of TMJ in joint reconstruction in children.20