New trends in posttraumatic soft tissue defect coverage

Posttraumatic soft tissue defects, alone or combined with fractures, still present challenging problems of diagnosis and choice of treatment, unless they are suitable for primary closure. The reasons are to be found in their varied ethiology and degree of severity. In order to apply the optimal therapy to the patient, a complete understanding of the defect present, an optimal timing of surgery and a full knowledge of all treatment options are mandatory. The treatment concept presented is based on our personal experience between 1981 and 1995 after more than 5000 skin transplantations, some 3000 local tissue fransfer, over 200 distat flap transfers and more than 1200 free microvascular tissue transfer to all regions of the body. New therapy concepts do not entirely replace the elder ones, but are integrated into the treatment schedule.