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
This review examined microsurgical reconstruction options for bony and soft tissue defects of the lower extremity, including muscle flaps, fasciocutaneous flaps, vascularized bone transfers, and functional muscle transfer for limb salvage. The abstract focuses on surgical planning, flap selection, bone grafting thresholds, and functional reconstruction techniques. For the American Society of Hirudotherapy, reconstructive microsurgery is a field where leech therapy has historically been used in flap salvage, but this abstract contains no mention of leeches, hirudotherapy, venous congestion, or the leech secretome. Its relevance is purely indirect; the article provides surgical context without any leech-related content.
Citación
Microsurgical Reconstruction of the Lower Extremity.
Pederson et al. · Seminars in plastic surgery, 2019
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026