Free Flaps in Reconstruction of the Lower Extremity

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Journal of the Korean Society for Surgery of the Hand 2004;13(2):123-129.
Published online October 31, 2004.

Jee-Hoon Hwang, M.D., Kun-Chang Lee, M.D., Tai-Suk Roh, M.D., Won-Min Yoo, M.D., Kwan-Chul Tark, M.D.

유리 피판을 이용한 다양한 하지 연부 조직 결손의 재건

황지훈·이건창·노태석·유원민·탁관철

Abstract

  Lower extremity injuries are frequently accompanied with large soft-tissue defects. Such Injuries are difficult to manage for its poor vascularity, rigid tissue distensibility, easy infectability and a relatively long healing period. Also, osteomyelitis, and/or non-union of the fractured bones are relatively common in lower extremity injuries and its weight-bearing role should be considered. Therefore, it is important to select appropriate reconstruction method of the lower extremities, which is applicable to a variety of surgical techniques according to these considerations. The goal of flap coverage in the lower extremity should not only be satisfactory wound coverage, but also acceptable appearance and minimal donor site morbidity.
  In this article, we have tried to establish a reconstruction method in the lower extremity based on our experiences and clinical analysis of soft tissue reconstruction using free muscle flap transfer in 27 cases from Jan. 2000 to Dec. 2002. The results showed 96% flap survival, and flap failure noted in one of the cases due to vascular insufficiency.
  In conclusion, we believe that in cases of lower extremity soft-tissue defects especially with open comminuted fractures and infections, muscle free flaps should be considered as the first line of treatment.

Key Words: Lower extremity, Soft-tissue defect, Free muscle flap

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