Turn over split fascial flap - a refinement for resurfacing shin defect.

Area of Science:

• Plastic Surgery
• Orthopedic Surgery
• Regenerative Medicine

Background:

• Moderate-sized shin defects from trauma or infection often require flap resurfacing.
• Existing flap techniques can result in undesirable bulkiness due to thin native subcutaneous tissue.
• A need exists for vascularized tissue with minimal bulk for optimal resurfacing.

Purpose of the Study:

• To introduce and evaluate a refined turnover fascial flap technique for resurfacing tibial defects.
• To address the aesthetic and functional limitations of conventional flaps in the shin region.

Main Methods:

• Cadaveric dissection and live microcirculation studies of fascia layers.
• Intraoperative fluorescein assessment of a split fascial flap.
• Clinical application in 5 cases of shin defects, covered with split skin grafts.

Main Results:

• The split fascial flap provided a thinner, larger surface area for defect coverage.
• Functional and aesthetic results were highly satisfactory in all 5 cases.
• An 18-month follow-up confirmed the flap's durability and usefulness.

Conclusions:

• The split fascial flap is an effective technique for resurfacing moderate shin defects.
• This method offers superior aesthetic and functional outcomes compared to bulkier flaps.
• The technique is durable and suitable for addressing defects in the upper and middle thirds of the tibia.