PRIMARY FLAP CLOSURE IN COMPLEX LIMB INJURIES

Free-tissue transfers enable surgeons to reconstruct or salvage limbs injured or amputated in high-energy traumas which result in extensive damage to soft tissue, bone, tendons, vessels and nerves. Primary free -tissue transfer is performed following debridement, bone fixation, an d repair of injured structures within 24 hr after injury. Between 1987 and 1996, 57 patients who had complex extremity traumas were treated with primary free-tissue transfer, or free flaps. Long-term follow-up ranged from 4 months to 9 years (median: 4.5 years). No flap failure o r serious wound-healing complication occurred using the protocol. Radi cal debridement and primary free-flap coverage in extensive extremity injuries can salvage limbs, provide improved functional and aesthetic results, and psychologically benefit patients through lowered morbidit y. Other benefits include reduced incidence of free-flap failure, post operative infection, secondary operative procedures, and invalidity, a s well as shorter hospital stays, and lowered medical expenses.