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Related Experiment Video

Updated: Sep 11, 2025

Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity
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Extremity preservation in traumatic and nontraumatic lower extremity defects.

Anna Fast1, Eva Placheta-Györi2, Thomas Rath1

  • 1Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna General Hospital, Währinger Gürtel 18-20, 1090, Vienna, Austria.

Wiener Klinische Wochenschrift
|August 18, 2025
PubMed
Summary

Lower extremity reconstruction using local flaps and microsurgical free flaps achieved high limb preservation rates. Both surgical methods are effective for complex wounds, with flap choice depending on defect characteristics and patient factors.

Keywords:
Free tissue transferLimb salvageMicrosurgeryReconstructive surgery

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Area of Science:

  • Orthopedic Surgery
  • Plastic Surgery
  • Reconstructive Surgery

Background:

  • Lower extremity reconstruction addresses diverse defects from trauma, infection, and tumors.
  • Flap surgery remains a critical yet challenging aspect of reconstructive procedures.
  • Advancements in plastic surgery continue to refine techniques for limb salvage.

Purpose of the Study:

  • To compare the efficacy of local flap surgeries versus microsurgical free flaps for lower extremity reconstruction.
  • To analyze postoperative complications and limb preservation rates associated with each flap type.
  • To identify factors influencing flap selection in complex lower extremity defects.

Main Methods:

  • A retrospective study of 187 patients treated at a tertiary care hospital.
  • Analysis of defects with traumatic (29.4%) and nontraumatic (70.6%) etiologies.
  • Collection of patient data, flap selection, and postoperative complications over a 12-month follow-up.

Main Results:

  • 104 free flaps and 83 local flaps were performed.
  • Latissimus dorsi and gracilis were common free flaps; gastrocnemius, soleus, and plantaris medialis were common local flaps.
  • An overall limb preservation rate of 92.5% was achieved, with no significant difference between flap groups.

Conclusions:

  • Both local and free flap techniques are viable for reconstructing complex lower extremity wounds.
  • Effective limb preservation is achievable with both reconstructive methods.
  • Flap selection is guided by defect location, size, and individual patient factors.