Lower limb reconstruction

Quite often the plastic surgeons are required to solve reconstructive problems at the lower limb, with the goal of repairing defects affecting the soft tissues (muscle, skin) and even bone in severe cases.

Usually we have to participate in the reconstructive process for severe injuries (traffic accidents, fallings) or ulcers due to infections or vascular diseases (diabetes). We have also to help to repair defects secondary to orthopaedic operations, such as osteosynthesis plates or screws or knee prosthesis. Most of the problems that we find are located at the knees and lower third of the leg, where there are less soft tissue and the vascularization is poorer.

For lower leg reconstruction we can use different techniques such as:

• Grafts: skinn trasplantation where the skin lives from the recipient bed.
• Flaps: the tissue is vascularized by an artery and vein. They can be cutaneous, muscular, bone and composite. depending on the type of vascularization the can be:
  • Pedicled
  • Island
  • Free (microvascularized, the artery and vein of the flap are sutured to the recipient artery and vein)

The advances in the anatomy and physiology of the vessels of the lower limb has allowed us to use different options without sacrifying any important artery of the leg.

The success rate for lower limb reconstruction is nowadays over 90%.

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