Palliative lower leg reconstruction

Palliative care is a multidisciplinary field that aims to relieve physical pain and psychological suffering with the goal of improving quality of life rather than focusing on curing or prolonging life. Plastic surgeons may have a role in this near end-of-life care through palliative reconstruction. The use of palliative reconstruction has been frequently described in the setting of head and neck and thoracic malignancies However, there is a paucity in the literature about the role of palliative reconstruction in the lower extremity. In this review, we provide a summary of the current literature in support of the benefits of palliative reconstruction in the lower extremity as well as three case examples to demonstrate scenarios in which palliative lower extremity reconstruction may be used for select patients. In order to determine whether a patient may benefit from palliative reconstruction to merit its risks, the treatment goals and limitations must be assessed on a case-by-case basis in collaboration with the patient. Careful patient selection, focus on patient's ambulatory and personal goals, and minimizing donor site morbidity are important considerations in palliative reconstruction of the lower extremity. Together with a multidisciplinary approach, plastic surgeons can provide valuable contributions to improve the quality of life for certain palliative oncological patients by providing palliative reconstruction of the lower extremity.