engleski

Long term results of microsurgical reconstruction of complex extremity defects

Introduction Complex extremity defects caused by civilian and war trauma or by resection of large malignant tumors present a challenge for reconstruction. Before the introduction of free tissue transfer most of these patients were treated with amputation. With the refinement of free tissue transfer and early reconstruction good functional and aesthetic results can be achieved. Patients and methods During the period from 1992 to 2002 we had treated 132 patients with complex defects of the extremities caused by trauma, war injuries or tumors with composite or functional microsurgical tissue transfer. Results In the early postoperative period 18 revisions were performed for arterial or venous thrombosis. Nine flaps were lost and 14 had some degree of partial necrosis. Additional procedures were performed in 27 patients and 5 developed osteomyelitis. Two to twelve years after reconstruction 63 patients were available for review. The review was performed using clinical evaluation, X-ray and questionnaire. The evaluation showed that 49, patients had good or excellent results while patient satisfaction was even higher. Most of the poor results were in the group of patients with secondary reconstructions. Conclusions Microsurgical reconstruction of complex extremity defects can provide good long term functional outcomes and patient satisfaction. Complications are lower and the results are better in patients with primary reconstruction.

complex extremity defects; microsurgical reconstruction

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