Soft-tissue reconstruction in severe lower extremity trauma. A review.

The reconstruction of soft tissues is a difficult aspect of limb salvage after severe lower extremity injury. Newer techniques such as free-tissue transfer can expedite wound care, decrease morbidity and hospital costs, and spare some limbs from amputation. It is important to know the mechanism of injury and the resultant zone of soft-tissue trauma. This is best defined by serial debridements over several days. The final defect size and composition will determine the type of soft-tissue flap used. Soft-tissue coverage may be accomplished with muscle, with muscle and skin transposition, or with free transfer. Microvascular transfers offer the advantage of one procedure that provides coverage for donor and recipient sites with early patient mobilization.