LOWER-LIMB SALVAGE IN A PATIENT WITH RECALCITRANT VENOUS ULCERATIONS

The authors report the salvage of a lower limb with recalcitrant venou s stasis ulcers by ''sequential'' free naps in a patient with co-exist ing chronic venous insufficiency and arterial occlusive disease. This presentation is interesting for inclusion of the following. (1) treatm ent of a recalcitrant venous ulcer by the combination of free-tissue t ransfer and valvular transplantation; (2) thrombosis of the free flap pedicle at an indeterminate time postoperatively without flap loss or leg ischemia; and (3) performance of a second free flap to the peronea l artery-only, to a one-vessel leg with an excellent clinical outcome at long-term follow-up.