A Comparative Analysis of Standard vs Jelonet/Gauze/Gamgee Dressing for Lower Limb Free Flap Reconstruction

Lower limb free flaps require regular monitoring in the immediate days postoperatively and often involve prolonged outpatient wound care. Post-operative dressings are complicated when a circular external fixator is used. Circumferential post-operative dressings are the standard option, such as Jelonet/gauze/wool/crepe. An alternative option is the use of Jelonet and gauze, with Gamgee (JGG) wrapped loosely over the frame instead. This allows easier monitoring with complete flap visualisation, avoids constriction and allows much quicker dressing application. This dressing option has been previously described, but no comparative study between standard dressings and JGG dressings has been made. A retrospective study was conducted for consecutive patients treated with a circular frame and free flap for reconstruction of either an acute open tibial fracture or fracture-related infection between January 2022 and October 2023. Demographics, comorbidities, perioperative details, flap and wound healing outcomes were recorded and analysed using Jamovi 2.3.21. Thirty-one patients (average age 43 years) were identified, 81% open fracture, 42% gracilis, 36% ALT. A total of 48% had standard dressings, and 52% JGG. No statistically significant difference was found between the dressing groups for flap failure, inpatient stay, or time to complete healing. This study demonstrates clinical equivalence in outcomes between standard and JGG dressings for this patient group. The JGG dressing also has the advantages of quick and easy application, with improved flap visualisation. We recommend its use in this patient group.

Jageer P, Kiely J, Day S, et al. A Comparative Analysis of Standard vs Jelonet/Gauze/Gamgee Dressing for Lower Limb Free Flap Reconstruction. Strategies Trauma Limb Reconstr 2025;20(1):56-58.