Two for the price of one: a keystone design equals two conjoined V-Y flaps

摘要

Lower limb reconstruction continues to pose a substantial clinical problem, with inherently high venous pressures in the lower limb due to gravitational effects, potentially incompetent veins and relative dependant oedema, all contributing to lower success rates with both flaps and grafts.1'2 A recently published abstract in the ANZ Journal of Surgery and presentation at the Royal Australasian College of Surgeons annual scientific congress by Ng and Coombs described the utility of the island V-Y advancement flap for lower limb defects.3 The authors successfully demonstrate the utility of V-Y island flaps in lower limb reconstruction, and we would like to offer some pertinent comments as to our continuing observations with related fasciocutaneous island flaps.