The «Propeller»–technique in plastic surgery of the extensive wounds of distal leg and the foot

Objective. To increase the efficacy of plastic surgery in treatment of the extensive soft tissue defects, applying “sparing” resection of the lower third of the shin and foot for consequences of mechanical and/or thermal trauma or infectious–necrotic processes.   Materials and methods. We conducted a retrospective evaluation of the “Propeller”–technique application for the elevation of the skin islet flaps on sural neurovascular pedicle in 11 patients, who underwent surgery between 2014 and 2017. The task for investigation was to eliminate the shin and foot defects, developed due to large–scale tissue damage. The Group 1 was organized for patients with the mine–blast trauma and the coal mine occupational injuries (2 patients followed in each category). Management of purulent–necrotic wounds (Group 2) was required in cases of amputation and resection of the foot due to either osteomyelitis (3 patients followed) or frostbites (4 patients followed).   Results. All the patients had an adequate vascular supply of the affected limbs, even in 3 patients from the Group II, who had only one artery preserved. In all cases a secondary surgical debridement, necrectomy and the soft tissue defect repair were performed during the same operation.   Conclusions. Using of the tegument tissues mobilization complex “Propeller”– technique is an effective instrument for sealing of deep complex defects of different etiology, localized in distal part of the lower extremity.