Timing of management of severe injuries of the lower extremity by free flap transfer.

Covering defects by free-tissue transfers enable surgeons to reconstruct or salvage the lower extremity injured or amputated in high-energy traumas which result in extensive damage to soft tissue, bone, tendons, vessels and nerve. The timing of the reconstruction using flap techniques is extremely important. It can be divided into three categories: "primary free flap closure" (12 to 24 hours), "delayed primary free flap closure" (2 to 7 days), and "secondary free flap closure" (after 7 days). Our treatment of choice in an isolated complex injury of a lower extremity with a soft tissue defect is "primary free flap closure" providing improved funcional and aesthetic results, and psychologically benefit through lowered morbidity of the patient.

[1]  A. Schwabegger,et al.  Perforator-Pedicled Skin Island Flap for Coverage of Microvascular Anastomoses in Myocutaneous Flaps in the Lower Extremity , 2003, Plastic and reconstructive surgery.

[2]  A. Schwabegger,et al.  A Single-Stage Operation in the Treatment of Chronic Osteomyelitis of the Lower Extremity Including Reconstruction with Free Vascularized Iliac Bone Graft and Free-Tissue Transfer , 2003, Plastic and reconstructive surgery.

[3]  E. K. Mooney,et al.  A new classification for the standardization of nomenclature in free flap wound closure. , 1999, Plastic and Reconstructive Surgery.

[4]  T. Schoeller,et al.  Primary Flap Closure in Complex Limb Injuries , 1997, Journal of reconstructive microsurgery.

[5]  K. Benedetto,et al.  [Infection prophylaxis in complex limb trauma through immediate definitive reconstruction via a free tissue transfer]. , 1997, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[6]  K. Benedetto,et al.  Emergency free flap cover in complex injuries of the lower extremities. , 1996, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[7]  M. Ninkovic,et al.  Emergency Free Tissue Transfer for Severe Upper Extremity Injuries , 1995, Journal of hand surgery.

[8]  G. Lister,et al.  Early Free‐Flap Coverage of Electrical and Thermal Burns , 1992, Plastic and reconstructive surgery.

[9]  M. S. Noordhoff,et al.  Emergency Free‐Flap Transfer for Reconstruction of Acute Complex Extremity Wounds , 1992, Plastic and reconstructive surgery.

[10]  P. Manson,et al.  Microvascular Soft‐Tissue Transplantation for Reconstruction of Acute Open Tibial Fractures: Timing of Coverage and Long‐Term Functional Results , 1992, Plastic and reconstructive surgery.

[11]  Z. Arnež.  Immediate reconstruction of the lower extremity--an update. , 1991, Clinics in plastic surgery.

[12]  F. Wei,et al.  Emergency free flaps to the type IIIC tibial fracture. , 1990, Annals of plastic surgery.

[13]  W. Breidenbach.  Emergency free tissue transfer for reconstruction of acute upper extremity wounds. , 1989, Clinics in plastic surgery.

[14]  Y. P. Low.  Management of open tibial fractures. , 1988, Singapore medical journal.

[15]  L. Scheker,et al.  Emergency free flaps to the upper extremity. , 1988, The Journal of hand surgery.

[16]  P. Manson,et al.  Acute and Definitive Management of Traumatic Osteocutaneous Defects of the Lower Extremity , 1987, Plastic and reconstructive surgery.

[17]  R. Richards,et al.  The influence of muscle flap coverage on the repair of devascularized tibial cortex: an experimental investigation in the dog. , 1987, Plastic and reconstructive surgery.

[18]  A. Banič,et al.  Latissimus Dorsi Free Flaps for Total Repair of Extensive Lower Leg Injuries in Children , 1987, Plastic and reconstructive surgery.

[19]  M. Godina.  Early Microsurgical Reconstruction of Complex Trauma of the Extremities , 1986, Plastic and reconstructive surgery.

[20]  G. Cierny,et al.  The Management of Open Tibial Fractures with Associated Soft‐Tissue Loss: External Pin Fixation with Early Flap Coverage , 1981, Plastic and reconstructive surgery.

[21]  S Nylén,et al.  Time factor, infection frequency and quantitative microbiology in hand injuries: a prospective study. , 1980, Scandinavian journal of plastic and reconstructive surgery.