Salvaging length for below-knee-level amputations after burn injury using muscle flaps, negative pressure wound therapy with instillation, and allograft skin

Abstract

We describe a case of severe flame burns to the bilateral lower extremities following a motor vehicle accident, which required bilateral split gastrocnemius and soleus flaps to obtain coverage of the below-knee-amputation stumps. Knowledge of the blood supply and location of the pedicles of these muscles is critical to their successful rotation in this context. The importance of allografts and negative pressure wound therapy prior to autografting is also emphasised. Limited access to allografts remains a considerable barrier for the South African reconstructive surgeon when trying to obtain successful wound coverage in burns and complex wounds.