Microsurgical Reconstruction of the Lower Extremity.
Review published in Seminars in plastic surgery (2019)
Abstract
Reconstruction of bony and soft tissue defects of the lower extremity has been revolutionized by the advent of microsurgical tissue transfer. There are numerous options for reconstruction. Possibilities include transfer of soft tissue, composite (bone and soft tissue) tissue, and functional muscle. Many lower extremity reconstructions require staged procedures. Planning is of paramount importance especially in regard to vascular access when multiple free flaps are required. Soft tissue reconstruction of the lower extremity may be accomplished with muscle flaps such as the rectus femoris and latissimus dorsi covered with a skin graft. Fasciocutaneous flaps such as the anterolateral thigh flap may be more appropriate in a staged reconstruction which requires later elevation of the flap. Loss of a significant portion of bone, such as the tibia, can be difficult to manage. Any gap greater than 6 cm is considered a reasonable indication for vascularized bone transfer. The contralateral free fibula is the donor site of choice. Functional reconstruction of the anterior compartment of the leg may be performed with a gracilis muscle transfer, effectively eliminating foot drop and providing soft tissue coverage. Muscle tensioning is critical for effective excursion and dorsiflexion of the foot. Long-term results of microsurgical reconstruction of the lower extremity show good results and reasonable rates of limb salvage.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Reconstruction of bony and soft tissue defects of the lower extremity has been revolutionized by the advent of microsurgical tissue transfer. There are numerous options for reconstruction.
Por qué esto importa para la hirudoterapia
Esta revisión examinó las opciones de reconstrucción microquirúrgica para defectos óseos y de tejidos blandos de la extremidad inferior, incluyendo colgajos musculares, colgajos fasciocutáneos, transferencias óseas vascularizadas y transferencia muscular funcional para el salvamento de la extremidad. El resumen se centra en la planificación quirúrgica, la selección del colgajo, los umbrales de injerto óseo y las técnicas de reconstrucción funcional. Para la American Society of Hirudotherapy (Sociedad Americana de Hirudoterapia), la microcirugía reconstructiva es un campo en el que la terapia con sanguijuelas se ha utilizado históricamente en el rescate de colgajos, pero este resumen no contiene ninguna mención a sanguijuelas, hirudoterapia, congestión venosa ni al secretoma de la sanguijuela. Su relevancia es puramente indirecta; el artículo aporta contexto quirúrgico sin ningún contenido relacionado con sanguijuelas.
Citación
Microsurgical Reconstruction of the Lower Extremity.
Pederson et al. · Seminars in plastic surgery, 2019
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026