Chronic Lower Extremity Wounds: Updates on Lower Extremity Reconstruction in Clinics in Plastic Surgery

Area of Science:

• Medicine
• Surgery
• Vascular Medicine

Background:

• Chronic lower extremity (LE) wounds are increasingly prevalent, causing significant morbidity, limb loss, and healthcare costs.
• Rising rates of diabetes, vascular disease, and an aging population contribute to the growing burden of LE wounds.
• Effective management necessitates a thorough understanding of wound pathophysiology, etiology, and patient-specific risk factors.

Purpose of the Study:

• To review the assessment and multidisciplinary management strategies for chronic lower extremity wounds.
• To emphasize key components of effective LE wound care, including infection control, vascular optimization, and biomechanical correction.
• To present institutional outcomes of a coordinated "vasculoplastic" approach for complex limb salvage in high-risk patients.

Main Methods:

• Review of current literature and clinical practices for chronic LE wound management.
• Emphasis on a multidisciplinary approach integrating infection control, vascular surgery, and biomechanical interventions.
• Analysis of institutional outcomes data for patients undergoing complex limb salvage with free tissue transfer for chronic LE wounds.

Main Results:

• A coordinated "vasculoplastic" approach can effectively manage complex chronic LE wounds.
• Free tissue transfer in limb salvage procedures demonstrated high flap success rates.
• The approach led to durable wound healing and significant functional recovery in high-risk patient populations.

Conclusions:

• Multidisciplinary management, particularly a coordinated "vasculoplastic" strategy, is crucial for addressing chronic LE wounds.
• Complex limb salvage using free tissue transfer is a viable option for high-risk patients with chronic LE wounds.
• This approach offers the potential for high flap success, durable healing, and meaningful functional recovery, reducing morbidity and limb loss.