Reconstruction of the Lower Extremity with Vascularized Composite Tissue

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Abstract
A retrospective assessment of 50 vascularized composite tissue transfers was carried out with 48 patients. Factors responsible for improved tissue survival included the evaluation and proper selection of recipient vasculature; the increased dependence on the vascularized latissimus dorsi musculocutaneous flap; and the frequent use, wherever possible, of an end-to-side arterial anastomosis. Specific indications for reconstruction of the lower extremity with vascularized composite tissue include avulsive injuries to the distal tibia and foot; the failure of conventional methods; the treatment of extensive chronic osteomyelitis; deficiency of soft tissue cover and skeletal support; the restoration of form and contour with minimal secondary deformity of the donor site; and extensive loss of soft tissue only. Reconstruction of the lower extremity with vascularized tissue is a reliable method with acceptable patient and tissue morbidity statistics that should be considered when specific indications are present.

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