Pretibial wounds are often associated with prolonged wound healing, particularly in the elderly female population. The wounds characteristically have either a proximally or distally based flap. Delayed wound healing has been attributed to flap necrosis and poor blood supply to this area. The aim of this review article is to examine the vascular anatomy, pathology and management options of patients with pretibial wounds.
Arnold TE, Stanley JC, Fellows EPet al.1994. Prospective, multicenter study of managing lower extremity venous ulcers. Ann Vasc Surg8: 356-362.
2.
Batchelor JS, Rahim A, McGuinness A.1995. The anatomical basis for arteriovenous shunting in fascial flaps. Plast Reconstr Surg95: 233-242.
3.
Batchelor JS, Moss ALH.1995. The relationship between fasciocutaneous perforators and their fascial branches: an anatomical study in human cadaver lower legs. Plast Reconstr Surg95: 629-633.
4.
Batchelor JS, McGuinness A.1996. A reappraisalof axial and non-axial lower leg fascial flaps: an anatomic study in human cadavers. Plast Reconstr Surg97: 993-1000.
5.
Batchelor JS, McGuinness A.1997a. Pedicled transposition fascial flaps in the lower leg. An anatomical study. Plast Reconstr Surg99: 1468-1470.
Batchelor JS, McGuinness A.1997c. The refined transposition suprafascial membrane flap for the treatment of pretibial flap lacerations. Clin Anat10: 353-353.
8.
Batchelor JS, Ryan J.1998. A three phase system of wound evaluation using a new Wound Classification System. J Emerg Med16(2S): 16-16.
Budny PG, Lavelle J, Regan PJet al.1993. Pretibial injuries in the elderly: a prospective trial of early mobilisation versus bed rest following surgical treatment. Br J Plast Surg46: 594-598.
11.
Cormack GC, Lamberty BGH.1984a. Fasciocutaneous vessels. Their distribution on the trunk and limbs, and their clinical application in tissue transfer. Anat Clin6: 121-131.
12.
Cormack GC, Lamberty BGH.1984b. A classification of fascio-cutaneous flaps according to their patterns of vascularisation. Br J Plast Surg37: 80-87.
13.
Crawford BS, Gipson M.1977. The conservative management of pretibial lacerations in elderly patients. Br J Plast Surg30: 174-176.
14.
Deodhar AK, Rana RE.1997. Surgical physiology of wound healing: a review. J Postgrad Med43: 52-56.
15.
Dunkin CS, Elfleet D, Ling Cet al.2003. A step-by-step guide to classifying and managing pretibial injuries. J Wound Care12: 109-112.
16.
Eaglstein WH.1989. Wound healing and aging. Clin Geri Med5: 183-188.
Edmunds LH, Stephenson LW, Edie RNet al.1988. Open-heart surgery in octogenarians. N Engl J Med319: 131-136.
19.
Evans CA, Hagelstein S, Ivins N.2000. Current challenges in wound care management: an overview. Br J Community Nurs5: 332-339.
20.
Foroughi D, Nouri DK.1990. Grafting without a donor site: an easy approach to pretibiallacerations. J R Coll Surg Edinb35: 245-247.
21.
Haertsch PA.1981. The blood supply to the skin of the leg: a post-mortem investigation. Br J Plast Surg34: 470-477.
22.
Haiart DC, Paul AB, Chalmers Ret al.1990. Pretibial lacerations: a comparison of primary excision and grafting with “defatting” the flap. Br J Plast Surg43: 312-314.
23.
Hunt TK, Pai MP.1972. The effect of variant oxygen tensions on wound metabolism and collagen synthesis. Surg Gynae Obstet135: 561-567.
24.
Hunt TK.1980. Disorders of wound healing. World J Surg4: 271-277.
Jones BM, Sanders R.1983. Pretibial injuries: a common pitfall. Br Med J286: 502-502.
27.
Laing R, Tan S, McDouall Jet al.2002. Pretibial injury in patients aged 50 years and over. N Z Med J13,115(1167): U274-U274.
28.
Marsden AK.1982. A fresh look at coal scuttle shin. In: Wilson DH, Marsden AK, eds. Care of the acutely ill and injured. Chichester: J Wiley and Sons: pp. 315-317.
29.
McGuinness A, Batchelor JS.1996a. The lower leg suprafascial areolar membrane flap. Its possible clinical use in pretibial wounds. J Accid Emerg Med13: 145-145.
30.
McGuinness A, Batchelor JS.1996b. The lower leg suprafascial areolar membrane flap. Its possible clinical use in reconstructive surgery. Clin Anat9: 199-199.
31.
Norris SO, Provo B, Stotts NA.1990. Physiology of wound healing and risk factors that impede the healing process. AACN Clin Issues Crit Care Nurs1: 545-552.
32.
Ramnani SR, Weston PAM.1981. Pretibial flap wounds: early grafting under regional anaesthesia as an out-patient procedure. Injury12: 360-364.
Ruberg RL.1984. Role of nutrition in wound healing. Surg Clin North Am64: 705-714.
35.
Russell L.2000. Understanding physiology of wound healing and how dressings help. Br J Nurs9: 12-21.
36.
Shankar S, Khoo CT.1987. Lower limb skin loss: simple out patient management with meshed skin grafts with immediate mobilisation. Arch Emerg Med4: 187-192.
37.
Sharpe DT, Cardoso E, Baheti V.1983. The immediate mobilisation of patients with lower limb skin grafts: a clinical report. Br J Plast Surg36: 105-108.
38.
Silk J.2001. A new approach to the management of pretibial lacerations. Injury32: 373-376.
39.
Stadelmann WK, Digenis AG, Tobin GR.1998. Impediments to wound healing. Am J Surg176(Suppl 2A): 39S-46S.
40.
Sutton R, Pritty P.1985. Use of sutures or adhesive tapes for primary closure of pretibial lacerations. Br Med J290: 1627-1627.
Wood SH, Lees VC.1994. A prospective investigation of the healing of grafted pretibial wounds with early and late mobilisation. Br J Plast Surg47: 127-131.
