[Surgical strategy for free flaps]

One third of covering flaps in our series (25 out of 79) were free flaps usually of latissimus dorsi or composites (rib, iliac crest or fibula) with only 5.5% of failures. The advantage of free flaps is that they can be harvested at a site remote from the injury without additional local trauma, their potential large volume and large area of coverage. They should only be transferred after a complete debridement as if for tumour (skin, muscle, bone) while preserving the neurovascular bundles and after verifying that plantar sensation has been maintained. Finally, it is fundamental that the anastomoses are done in a healthy region if need be with the aid of intercalary vein grafts.