A Novel Utility of Bilobed Flap for Amputation Stump Coverage

Abstract

Amputations are catastrophic events in someone's life. The amputation stump can be problematic, which may lead to soft tissue loss. Varieties of stump defect closure have been reported, ranging from the simplest to advanced soft tissue closure requiring microsurgical skills. 1 Aiming to provide a well-padded, stable, sensate, and painless soft tissue coverage to allow for the wearing of a well-fitted prosthesis, we chose a simple technique of using the bilobed flap.The bilobed flap is a local transposition flap designed for small-to moderate-sized defects on the facial region. 2 Since its first introduction by Esser 3 in 1918 for nasal tip reconstruction, numerous modifications have been made. Tissiani et al 4 describe the use of the bilobed flap in 42 cases in a wide range of anatomical sites, including the cheek, lip, thumb, and foot. Other literature reported its utilization for small foot ulcers and other small pathologies such as mucoid cysts. [5][6][7] We aimed to utilize this technically easy flap for better management of defect closure on amputated limb stumps that can benefit patients in areas without microsurgery service. To our knowledge, this is the first report of its utilization for large defects, particularly for stump defect closure. 8 METHODSTwenty-eight cases were treated with bilobed flaps as soft tissue defect closure from 2018 to 2022 in our center. Cases of the amputation stump coverage were included, and patients with a follow-up time less than 6 months or lost to follow-up were excluded. The main objective of this Reconstructive