SINGLE-STAGE REVASCULARIZATION AND FREE-FLAP COVERAGE IN THE TREATMENT OF ISCHEMIC LOWER-LIMB LESIONS

Old age, diabetes and atherosclerotic disease all have been considered to be relative contraindications for microsurgery. As such, gangrenou s lesions of the lower limb traditionally resulted in staged amputatio ns. A more aggressive approach, combining revascularization and free t issue transfer, allowed us to limit the level of amputation and to sta rt early ambulation and rehabilitation, without the need for major ort hotic help. Performing the vascular procedure, debridement, and free t issue transfer in one single intervention greatly reduces the number o f operative procedures without substantial increase it operative time. Twenty consecutive patients underwent a combined free flap and revasc ularization procedure, two patients died perioperatively. One free fla p was lost and needed replacement. All surviving patients were ambulat ing postoperatively.