Publication: Experience in Flap Reconstruction of Lower Limb Defects in a Tertiary Care Center of Nepal
| creativeworkseries.issn | ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987 | |
| dc.contributor.author | Niraula, Himalaya | |
| dc.contributor.author | Rajbhandari, Bikesh | |
| dc.contributor.author | Devkota, Manish | |
| dc.contributor.author | Sharma, Samit | |
| dc.contributor.author | Rayamajhi, Sangam | |
| dc.contributor.author | Shrestha, Jayan M | |
| dc.contributor.author | Lohani, Ishwar | |
| dc.date.accessioned | 2026-03-17T07:49:19Z | |
| dc.date.available | 2026-03-17T07:49:19Z | |
| dc.date.issued | 2021 | |
| dc.description | Himalaya Niraula, Bikesh Rajbhandari, Manish Devkota, Samit Sharma, Sangam Rayamajhi, Jayan M Shrestha, Ishwar Lohani Department of Plastic Surgery and Burns, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, Kathmandu, Nepal | |
| dc.description.abstract | ABSTRACT Introduction: Lower limb defects are caused by trauma, chronic ulcers or oncological resection. Being a large and varied area of the body, lower limb reconstruction is challenging. This study analyzed clinical presentation of such defects, surgical management and outcomes in Nepalese context. Methods: Single-center retrospective study of flap reconstruction of lower limb defects conducted in Tribhuvan University Teaching Hospital, Kathmandu over a two years period (April 2019-March 2021). Demographics, clinical presentation, comorbidities, treatment and complications were recorded and analyzed. Results: A total of 53 flaps were performed on 47 patients with 50 defects (35 males and 12 females). Road traffic accidents (38.3%) and pressure ulcers (17.02%) were common causes. Ankle-foot was the most affected site (48%), followed by leg and thigh (18% each). Defect size ranged from 3 cm2 to 396 cm2. Surgery consisted of 46 pedicled and seven free flaps. Reverse sural artery flap was the commonest flap performed (30.2%). All free flaps were performed on defects larger than 100cm2. Overall complication rate was 30.2%, partial flap loss being the commonest (15.1%). Total flap loss occurred in one pedicled and one free flap. Eleven pressure ulcers were operated on, with 36.4% complication rate. Average hospital stay was 33.5±26.88 days. Conclusion: Multiple surgeries, comorbidities and high complication rates with hospital stay of more than a month reflect the difficulties encountered in lower limb reconstruction. Despite these challenges, majority of our patients were discharged with stable wound coverage. Keywords: Lower limb reconstruction, pressure ulcers, reverse sural artery flap | |
| dc.identifier.uri | https://hdl.handle.net/20.500.14572/5186 | |
| dc.language.iso | en_US | |
| dc.publisher | Institute of Medicine | |
| dc.subject | Lower limb reconstruction | |
| dc.subject | pressure ulcers | |
| dc.subject | reverse sural artery flap | |
| dc.title | Experience in Flap Reconstruction of Lower Limb Defects in a Tertiary Care Center of Nepal | |
| dc.type | Article | |
| dspace.entity.type | Publication | |
| local.article.type | Original Article | |
| oaire.citation.endPage | 34 | |
| oaire.citation.startPage | 30 | |
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