Combined Tissue Transfer for Extensive Lower Limb Complex Defects: Flow-through Flaps, Chimera, and "Orochi" Flaps

Area of Science:

• Reconstructive Surgery
• Microsurgery
• Tissue Engineering

Background:

• Complex lower limb defects, such as those caused by osteomyelitis, present significant reconstructive challenges.
• Traditional methods may involve extensive donor-site morbidity and limited reconstructive options.

Purpose of the Study:

• To demonstrate the application of combined tissue transfers using perforator flaps for severe complex leg defects.
• To highlight the utility of chimeric or "Orochi" type combined transfers.

Main Methods:

• Utilizing minimally invasive perforator flaps combined with well-vascularized bone flaps.
• Employing reliable revascularization techniques like bypass, flow-through, or vein grafts.
• Integrating vascularized nerve flaps for cases with nerve palsy.

Main Results:

• Combined tissue transfers allow for the creation of custom-made composite flaps tailored to specific defect requirements.
• These methods facilitate effective revascularization and reconstruction of complex lower extremity injuries.
• The approach minimizes donor-site deformity.

Conclusions:

• Combined tissue transfers with perforator flaps are effective for reconstructing severe complex leg defects.
• Future advancements suggest increased availability of less invasive donor site techniques for combined tissue transfers.