J Reconstr Microsurg 2004; 20(8): 621-629
DOI: 10.1055/s-2004-861522
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Can Indications for Lower Limb Replantation and Revascularization be Expanded with Simultaneous Free-Flap Transfer for Limb Salvage?

Tayfun Akoz1 , Serkan Yildirim1 , Mithat Akan1 , Kaan Gideroglu1 , Gülden Avci1 , Bariş Cakir1
  • 1Department of Plastic and Reconstructive Surgery, Kartal Dr. Lütfü Kirdar Education and Research Hospital, Istanbul, Turkey
Further Information

Publication History

Publication Date:
03 January 2005 (online)

ABSTRACT

High-energy trauma from road accidents and work-related injuries is the most common cause of lower-limb traumatic amputations. Many of these cases require extensive debridement and substantial bone shortening for primary closure because of crushing and/or avulsion of the involved parts. Since 1998, the authors have replanted or revascularized five lower limbs in five patients. Free tissue transfers have been used to cover soft-tissue defects during replantation and revascularization in all patients. The numbers and kinds of free flaps include one latissimus dorsi muscle, two transverse rectus abdominis musculocutaneous (TRAM), and two anterolateral thigh fasciocutaneous flaps. Survival of the replanted and revascularized limbs and transferred flaps was obtained in four patients. Below-knee amputation was performed because of flap necrosis and extensive infection in one patient. Simultaneous free-tissue transfers may be used simultaneously with lower limb replantation or revascularization to obtain functional extremities in appropriately selected patients. The indications for lower limb salvage may be enhanced and successful results may be obtained in one stage, with low complication rates and shorter hospital stays. The authors report their experience with simultaneous free tissue transfers and lower limb replantation or revascularization.

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Tayfun AkozM.D. 

Guniz Eker, P.K. 26

34842 Küçükyah, Istanbul, Turkey