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Changes in donor site selection in lower limb free flap reconstructions
Author(s) -
Boeckx W.,
van den Hof B.,
van Holder C.,
Blondeel P.
Publication year - 1996
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/(sici)1098-2752(1996)17:7<380::aid-micr7>3.0.co;2-k
Subject(s) - medicine , vascularity , free flap , surgery , soft tissue , free flap reconstruction , microsurgery , heel , head and neck , osteomyelitis , anatomy
Since 1973 we have performed over 1,000 free flap reconstructions mainly in head and neck, breast, and upper and lower limb surgery. In lower leg reconstructions, changing indications for flap selection were not only correlated to new anatomical developments, but mainly due to a better understanding of adaptability of known muscle or fascial free flaps. Reducing donor site morbidity and planning for saving donor sites for future reconstructions are important. Morbidity is reduced by selection of free flaps ideally adjusted to the shape of the defect. Innervated free flaps or functional muscle transplants are rarely indicated in the lower leg. In the early years of microsurgical free flaps, soft tissue reconstruction or bone coverage was the primary indication. Later improving the vascularity of the wound bed by free flap cover increased the indication to chronic infected leg ulcers, osteomyelitis, diabetes, or artheriosclerotic wound defects or pressure sores due to lack of sensibility. Reconstruction of the foot and restoring its weight‐bearing capacity is one of the more challenging applications of free flap cover. © 1997 Wiley‐Liss, Inc. MICROSURGERY 17:380–385 1996