Refinements of Free Tissue Transfer for Optimal Outcome in Lower Extremity Reconstruction

Christopher A. Marek, Lee Li-Qun Pu, John T. Lindsey

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Advances in microsurgery have revolutionized the management of severe lower extremity soft tissue injuries. However, the final optimal result, such as cosmesis, is only of secondary concern as limb salvage is the ultimate goal in reconstruction. In a continuous effort to obtain the best possible outcome for patients, several refinements of free tissue transfers in lower extremity reconstruction have been made. Over the past 2 years, 14 patients (8 males: 6 females; ages 14 to 65 years) underwent lower extremity reconstructions with free muscle flaps (7 gracilis, 3 rectus abdominus, and 4 latissimus dorsi) and split-thickness skin grafts for various soft tissue defects. All patients have obtained excellent cosmetic and reconstructive outcomes with an average of 1-year follow-up. Based on our results, the following refinements are recommended: (1) selection of donor muscle flap appropriate to the size and contour requirements of the defect; (2) meticulous flap inset into the defect; and (3) if necessary, final flap debulking by tangential excision for optimal contouring.

Original languageEnglish (US)
Pages (from-to)270-275
Number of pages6
JournalAnnals of Plastic Surgery
Issue number3
StatePublished - Mar 2004
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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