Abstract
Purpose of Study: In the UK locoregional soft tissue cover is more traditionally within the remit of Plastic Surgeons. Currently only seven hospitals in the UK have Plastic Surgical units within trauma hospitals so that soft tissue cover often requires patient transfer between hospitals, with associated significant delays to surgery. This study set out to identify whether the current practice of soft tissue cover by an orthopaedic surgeon was justified.
Methods: 21 patients with a mean age of 44 years (range 7–87 years) had locoregional soft tissue cover surgery since 1996.
Results: Of 15 patients with open tibial fractures 3 (16%) went on to require an amputation at a mean of 10 months after injury (range 2–21 months). The mean delay between injury and soft tissue cover was 9 days (range 0–51 days). 11 cases went on to union at a mean of 7 months (range 4–11 months). 4 cases are yet to achieve union.
Of 22 flaps carried out there were only two flap failures. One was revised successfully with a gastrocnemius flap, whilst the other required a free latissimus dorsi flap which also failed requiring an above knee amputation.
Conclusions: These results are comparable to those from Plastic Surgical units. Locoregional soft tissue cover in the lower limb is therefore still safely within the remit of the Orthopaedic Surgeon. In the present economic climate there are strong financial incentives for avoiding transfer of trauma patients to other centres for such surgery.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
