Lower limb soft tissue reconstruction using microsurgical techniques

Trauma is the main cause of lower limb soft tissue defects followed by tumor resection, vascular disease and osteomyelitis. 17 patients were operated on using microsurgical techniques during the last 10 years. 9 of the patients had traumatic defects, 5 had various malignant tumors, 2 patients had arterial insufficiency and finally 1 patient had chronic osteomyelitis. The latissimus dorsi either as muscle flap with a split thickness skin graft or as a musculocutaneous flap was used the most frequently in our series. Other flaps, including the radial forearm neurovascular flap, the rectus abdominis flap, the scapular flap, the groin and the dorsalis pedis flaps were used less often. Delayed primary cover was used, except in 1 case with an opened knee joint trauma, where emergency repair was performed. Complications included: 2 partial skin graft necroses which required revision and 2 flap necroses caused by venous thrombosis. With follow-up more than 4 years in all but 2 patients, functional results were found satisfactory. Cosmetic results, however, were less satisfactory.