RECONSTRUCTIVE SURGERY FOR LOWER-LIMB SALVAGE .4.

The authors review the principles of reconstructive surgery for lower limb salvage after severe lower limb trauma to determine factors that have been used as decision-making criteria for limb salvage or amputat ion in severe lower extremity injuries and the methods of reconstructi on and their outcome. The use of scoring systems and their value in ac ute decision making (primary amputation or limb salvage) are described . Soft-tissue reconstructive techniques, with emphasis on the use of f laps and the importance of selecting the best technique and time for t he reconstruction are reviewed. Skeletal reconstructive techniques are described, including available options and currently held views on in dications and use of the best contemporary methods. It is essential fo r the physician to make a good initial decision on the need for primar y amputation or limb salvage. A multidisciplinary approach is fundamen tal to successful salvage.