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.
KEYWORDS
Lower limb salvage - free tissue transfer - replantation - revascularization
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Tayfun AkozM.D.
Guniz Eker, P.K. 26
34842 Küçükyah, Istanbul, Turkey
