Journal
SEMINARS IN PLASTIC SURGERY
Volume 36, Issue 4, Pages 233-242Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0042-1758205
Keywords
negative pressure wound therapy; fractures; lower extremity
Categories
Ask authors/readers for more resources
This article presents an algorithm for lower-extremity reconstructive management, emphasizing the importance of establishing a clean and living wound as the basis for reconstruction. It also discusses the preference for microvascular free-tissue for definitive soft-tissue coverage.
Composite injuries to the lower extremity from etiologies including trauma and infection present a complex dilemma for the reconstructive surgeon, and require multidisciplinary collaboration amongst plastic, vascular, and orthopaedic surgical specialties. Here we present our algorithm for lower-extremity reconstructive management, refined over the last decades to provide an optimized outcome for our patients. Reconstruction is predicated on the establishment of a clean and living wound, where quality of the wound-bed is prioritized over timing to soft-tissue coverage. Once established, soft-tissues and fractures are provisionally stabilized; our preference for definitive coverage is for microvascular free-tissue, due to the paucity of healthy soft-tissue available at the injury, and ability to avoid the zone of injury for microvascular anastomosis. Finally, definitive bony reconstruction is dictated by the length and location of long-bone defect, with a preference to utilize bone transport for defects longer than 5 cm.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available