Posttraumatic soft tissue defects, alone or combined with fractures, s
till present challenging problems of diagnosis and choice of treatment
, unless they are suitable for primary closure. The reasons are to be
found in their varied ethiology and degree of severity. In order to ap
ply the optimal therapy to the patient, a complete understanding of th
e defect present, an optimal timing of surgery and a full knowledge of
all treatment options are mandatory. The treatment concept presented
is based on our personal experience between 1981 and 1995 after more t
han 5000 skin transplantations, some 3000 local tissue fransfer, over
200 distat flap transfers and more than 1200 free microvascular tissue
transfer to all regions of the body. New therapy concepts do not enti
rety replace the elder ones, but are integrated into the treatment sch
edule.