Microvascular free tissue transfer after arterial revascularization in the elderly: an alternative to amputation

Extensive tissue loss associated with ischemia is a common problem in the elderly population with vascular insufficiency. This study involves 3 patients who underwent free tissue transfer following arterial revascularization for limb salvage. Latissimus dorsi, internal oblique muscles, and temporoparietal fascia free flaps were used. Two patients had the recipient vessel reconstituted by collaterals after complete atherosclerotic occlusion. There were no postoperative complications, and the reconstructive procedure never precipitated ischemia of the revascularized extremity. We conclude that free tissue transfers can be performed safely with good functional results in elderly patients. Such transfers should be considered an alternative to amputation and a rational step after arterial revascularization for limb salvage in patients with complex, nonhealing soft tissue defects.