L D and serratus flap for total shin degloving

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3 years post op


after 3 years
degloving injury

After external fixation

Condition of ankle

After one debridement

vessel dissection for free lap

LD and Serratus ant flap irrigation with antibiotic solution



flap bed irrigation

Skin grafting done after three weeks








finally healed flap
Degloving injuries are common occurrence in modern industrial society with mechanical transportation. In this injury the skin gets sheared from under lying fascia. All the vascular supply  to skin gets damage resulting in skin Loss. Replacing all big wound skin can be daunting task. Especially if whole leg is involved.

21 year old hotel management student suffered road traffic accident which resulted in shearing of whole skin of shin till ankle. He came to my hospital . We debrided and put a external fixator. After two days he was taken again in which we transferred free LD muscle along with serratus anterior flap .  Flap vessel 
We're connected to anterior tibial vessels.
Post operative patient was okay . By second week post operative he started developing fever . We started irrigation with antibiotics guided by culture reports. Fever took one week to settle down. After one month of surgery flap was skin grafted .
Slowly patient started showing recovery and after one month external fixator was removed. For next three months he was on dressing and all wounds healed up. 
He developed ankle pain for which arthrodesis was done 

Dr Adhishwar Sharma 8860650846

adhishwar@live.com



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