VASCULAR IMPAIRMENT AND FREE TISSUE TRANSFER IN THE LOWER-EXTREMITY

Fourteen patients with arteriosclerotic peripheral vascular disease an d extensive tissue defects of the lower extremity, underwent microsurg ical reconstruction using free tissue (''free flap'') transfer. It was possible to provide coverage in ten of these patients. Analysis of th is small series showed that only six of these ten patients were able t o resume unassisted ambulation. The authors discuss technical aspects of microsurgical reconstruction in this unfavorable group of patients. Analysis of this small series suggest that: (1) inadequate patient mo tivation, and (2) inability to form granulation tissue in the soft tis sue defect, either before or after a vascular reconstructive procedure , are both strong contraindications to microvascular free flap reconst ruction in patients with arteriosclerotic peripheral vascular insuffic iency of the lower extremity.