Lower limb salvage in trauma

The primary goal of limb salvage is to restore or maintain function. To achieve this goal, proper patient selection, timely reconstruction, and choosing the procedure best suited for the patient are paramount. The decision to salvage a limb should be individualized for each patient, taking into consideration not only the extremity wound but also the associated injuries, age, and socioeconomic status of the patient. Aggressive débridement and skeletal stabilization, followed by early reconstruction, are the current standard of practice and give better results than the more traditional approach of repeated débridements and delayed flap cover. Free tissue transfer remains the best choice for large defects, but local fasciocutaneous flaps are a reasonable alternative for smaller defects and cases in which free flaps are deemed not suitable.