Reconstruction of the soft tissue deffect of lower extremity in complicated case.

Lee, Jeong Soo; Kwon, Taek Keun; Lee, Dong Jin; Cha, Jin Han; Kim, Yang Woo

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1998;25(4):686-696.
Published online June 1, 1998.

Reconstruction of the soft tissue deffect of lower extremity in complicated case.

Jeong Soo Lee, Taek Keun Kwon, Dong Jin Lee, Jin Han Cha, Yang Woo Kim

Abstract

This study includes 19 cases of complicated low extremity injury to whom underwent microvascular free-tissue transfer in cases of open comminuted fracture, osteomyelitis, and vascular compromise or extensive soft tissue defect from Nov. 1994 to July 1997. The average time after injury to coverage was 25 days. The nineteen patients underwent a total of nineteen free tissue transfers primarily, and eighteen (94.7 per cent) of the transfers survived. Major complications were encountered recurrent failure of the free tissue transfer in one patient and partial necrosis in the other flap, which were successfully treated by flow-through radial forearm free flap and distally based superficial sural artery flap respectively. Two patients were sustained below knee amputation, one above knee amputation, despite of survival of flaps. This reveals limb salvage in 84 percent. The microvascular reconstruction is a versatile and reliable methods in complicated cases after severe trauma. Free tissue transplantation should be considered as a primary treatment in such complicated cases.