FREE-FLAP STEAL HASTENING AMPUTATION OF A REVASCULARIZED LOWER-LIMB

Complex limb threatening wounds secondary to end-stage atherosclerotic peripheral occlusive disease remain significant challenges that frequ ently mandate vascularized tissue coverage that can only be achieved w ith a microsurgical composite tissue transfer. Following or concurrent with limb revascularization, the theoretical risk that such a free fl ap could divert flow to a comparably lower resistance system of the fl ap has been previously considered hypothetical. We present a case repo rt where we believe such a ''steal syndrome'' did occur as suggested b y arteriogram, and this adverse phenomenon hastened limb amputation. T his possible risk must be carefully explained and accepted by these pa tients prior to embarking on these complex limb salvage attempts.