Chichery A, Mojallal A, Soubirac L, Breton P
Service de chirurgie plastique, centre hospitalier Saint-Luc-et-Saint-Joseph, 20, quai Claude-Bernard, 69007 Lyon, France.
Ann Chir Plast Esthet. 2007 Dec;52(6):582-9. doi: 10.1016/j.anplas.2007.02.010. Epub 2007 Apr 6.
Major causes of ballistic wounds are shooting accidents. Goals of this work are to suggest a position about ballistic wounds of leg's distal third. Reconstruction of ballistic wounds of leg's distal third is difficult, because of lack of laxity and veinous drainage in distal third; and characteristics of ballistic wounds. Ballistic traumas give a temporary cavity, which induce levelled wounds of neurovascular pedicules. We present three cases. One patient benefits from a sural flap, whereas the two others benefit respectively from a free parascapular flap and a free latissimus dorsi flap with free osseous graft. Functional results were considered as good. Treatment of ballistic wounds ask for certain specificities: 1) meticulous evaluation of wounds; 2) evaluation of vascular axis of leg. Debridments are numerous under general anaesthesia before a reconstruction with axial regional flap or free flap, which vessels are anastomosed distant. Reconstruction must be done before the tenth day.
