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Single-stage revascularization and free flap coverage in the treatment of ischemic lower limb lesions

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Abstract

Old age, diabetes and atherosclerotic disease all have been considered to be relative contraindications for microsurgery. As such, gangrenous lesions of the lower limb traditionally resulted in staged amputations. A more aggressive approach, combining revascularization and free tissue transfer, allowed us to limit the level of amputation and to start early ambulation and rehabilitation, without the need for major orthotic help. Performing the vascular procedure, debridement, and free tissue transfer in one single intervention greatly reduces the number of operative procedures without substantial increase in operative time. Twenty consecutive patients underwent a combined free flap and revascularization procedure, two patients died perioperatively. One free flap was lost and needed replacement. All surviving patients were ambulating postoperatively.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, University Hospital, Ghent, Belgium

    K. Van Landuyt, S. Monstrey, P. Tonnard & G. Matton

  2. Department of Vascular Surgery, University Hospital, Ghent, Belgium

    F. Vermassen & F. van den Brande

Authors
  1. K. Van Landuyt
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  2. F. Vermassen
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  3. S. Monstrey
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  4. P. Tonnard
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  5. F. van den Brande
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  6. G. Matton
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Van Landuyt, K., Vermassen, F., Monstrey, S. et al. Single-stage revascularization and free flap coverage in the treatment of ischemic lower limb lesions. Eur J Plast Surg 19, 245–252 (1996). https://doi.org/10.1007/BF00171878

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