The Fate of Lower Extremities with Failed Free Flaps

This study reviews the outcome of patients with failed free Haps to lower extremities. The failure rate was 10 percent (41 of 413 flaps) over a 13-year period. Trauma patients (83 percent of all patients) had a failure rate of 11 percent., while nontrauma patients had a failure rate of 6.7 percent....

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Veröffentlicht in:Plastic and reconstructive surgery (1963) 1996-10, Vol.98 (5), p.834-840
Hauptverfasser: Benacquista, Theresa, Kasabian, Armen K, Karp, Nolan S
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container_title Plastic and reconstructive surgery (1963)
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creator Benacquista, Theresa
Kasabian, Armen K
Karp, Nolan S
description This study reviews the outcome of patients with failed free Haps to lower extremities. The failure rate was 10 percent (41 of 413 flaps) over a 13-year period. Trauma patients (83 percent of all patients) had a failure rate of 11 percent., while nontrauma patients had a failure rate of 6.7 percent. The most common cause of failure was venous thrombosis (34 percent). Eight of 36 patients (22 percent) went on to amputation after the failed free Hap; all were trauma patients. Patients with tibia-fibula fractures had a 35 percent amputation rate (6 of 17 patients) after a failed free flap. Seventy-eight percent of the patients (28 of 36) had salvage of their extremities by split-thickness skin graft, local Haps, or a second free flap. Long-term follow-up was available in 24 of 36 patients (67 percent), 20 of whom were salvaged without amputation. Of the patients whose limbs were salvaged, none had undergone an amputation at a mean follow-up of 6.2 years. All were ambulating, but 7 (35 percent) had intermittent wound breakdown. Despite an initial free-flap loss, the majority of extremities can be salvaged with subsequent procedures. However, on long-term follow-up, a large percentage of patients continue to have wound problems. (Plast. Reconstr. Surg. 98834, 1996.)
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The failure rate was 10 percent (41 of 413 flaps) over a 13-year period. Trauma patients (83 percent of all patients) had a failure rate of 11 percent., while nontrauma patients had a failure rate of 6.7 percent. The most common cause of failure was venous thrombosis (34 percent). Eight of 36 patients (22 percent) went on to amputation after the failed free Hap; all were trauma patients. Patients with tibia-fibula fractures had a 35 percent amputation rate (6 of 17 patients) after a failed free flap. Seventy-eight percent of the patients (28 of 36) had salvage of their extremities by split-thickness skin graft, local Haps, or a second free flap. Long-term follow-up was available in 24 of 36 patients (67 percent), 20 of whom were salvaged without amputation. Of the patients whose limbs were salvaged, none had undergone an amputation at a mean follow-up of 6.2 years. All were ambulating, but 7 (35 percent) had intermittent wound breakdown. 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subjects Amputation
Female
Fibula - injuries
Foot Injuries - surgery
Humans
Leg Injuries - surgery
Male
Microsurgery
Postoperative Complications
Retrospective Studies
Surgical Flaps
Thrombophlebitis - etiology
Tibial Fractures - surgery
Treatment Failure
title The Fate of Lower Extremities with Failed Free Flaps
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