Comparative analysis of the effectiveness and frequency of complications in the use of the "flap within a flap" technique and traditional techniques of reconstruction with skin fascial flaps of the forearm

Reconstruction of large skin and soft tissue defects requires the use of reliable techniques that ensure optimal restoration of function and aesthetics. Compared to standard fasciocutaneous flaps, the “flap-in-flap” technique, which involves the creation of an additional movable segment inside the main flap, is attracting more and more attention. The purpose of the study is a comparative analysis of the effectiveness of traditional methods for closing large skin and soft tissue defects and the innovative “flap within a flap” technique. Data from 161 patients who underwent skin restoration using various methods were analyzed. The comparison group included traditional skin flaps, while the study group used a modified flap-within-a-flap technique. The flap survival rates, complication rates, rehabilitation time, and aesthetic results were assessed. The “flap-in-flap” technique showed the best results according to all evaluation criteria, which allows us to consider it as a promising alternative in reconstructive surgery.