GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW (Jun 2021)

Multistep reconstruction of a post-traumatic defect in the lower limb with AV loop and free myocutaneous latissimus dorsi flap combined with a perforator monitor skin island after loss of ALT flap

  • Summer, Tobias,
  • Abou Mrad, Mazen,
  • Bota, Olimpiu,
  • Bienger, Kevin,
  • Dragu, Adrian

DOI
https://doi.org/10.3205/iprs000155
Journal volume & issue
Vol. 10
p. Doc05

Abstract

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Crush injuries of the lower extremity with extensive osseous and soft tissue damage impose a big challenge even for an interdisciplinary reconstructive approach. Multistep reconstruction with negative wound pressure therapy for soft tissue management and external fixation for osseous stability preceding free flap transfer leads to optimized outcome. We report the successful multistep reconstruction of a third-deree open right tibial fracture with extensive soft tissue defect with an arteriovenous loop preceding latissimus dorsi flap coverage with a perforator skin island after loss of an anterior lateral thigh (ALT) flap due to intima damage of the recipient vessels. The described method is a safe reconstructive concept after primary flap loss with persistent extensive tissue damage.

Keywords