About cover of ballistic wounds of distal third of leg in civilian ways |
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Authors: | Chichery A Mojallal A Soubirac L Breton P |
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Institution: | Service de chirurgie plastique, centre hospitalier Saint-Luc-et-Saint-Joseph, 20, quai Claude-Bernard, 69007 Lyon, France. armelle.chichery@yahoo.fr |
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Abstract: | Major causes of ballistic wounds are shooting accidents. Goals of this work are to suggest a position about ballistic wounds of leg's distal third. Reconstruction of ballistic wounds of leg's distal third is difficult, because of lack of laxity and veinous drainage in distal third; and characteristics of ballistic wounds. Ballistic traumas give a temporary cavity, which induce levelled wounds of neurovascular pedicules. We present three cases. One patient benefits from a sural flap, whereas the two others benefit respectively from a free parascapular flap and a free latissimus dorsi flap with free osseous graft. Functional results were considered as good. Treatment of ballistic wounds ask for certain specificities: 1) meticulous evaluation of wounds; 2) evaluation of vascular axis of leg. Debridments are numerous under general anaesthesia before a reconstruction with axial regional flap or free flap, which vessels are anastomosed distant. Reconstruction must be done before the tenth day. |
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Keywords: | Traumatisme balistique Profil lésionnel de Fackler Lambeau pédiculé Lambeau libre Parage |
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