RECONSTRUCTIVE SURGERY

LOWER LIMB RECONSTRUCTION

Lower limb reconstruction is surgery to rebuild parts of the foot, ankle and leg after a defect from trauma, cancer, or previous surgery. Reconstructive surgery of the lower limb is a highly complex procedure and may be necessary for the following reasons:

• Extensive soft tissue or bone injury as a result of trauma
• Bone infection
• Recurrent injuries or open wounds due to diabetes or vascular disease
• Open artificial joints after joint replacement surgery.
• Exposed grafts used to restore blood flow to the lower limb after vascular surgery.
• Open wounds following excision of soft tissue tumours

Lower limb reconstruction aims to restore form and function to the foot, leg, hip or thigh. This is achieved through a combination of surgical procedures or utilising surrounding tissue from the lower limb to reconstruct these defects. In some instances, microsurgical procedures may be necessary in which tissue is transferred from one area of the body to the affected limb to accomplish the reconstruction.

PROCEDURE

Flaps of skin, tissue and/or bone together with their underlying blood vessels and muscle are used to reconstruct the defect in the lower extremity. Through these forms of reconstruction, shorter limbs and amputation may sometimes be prevented.

Skin grafts and flap transfer are some of the techniques used to reconstruct the lower limb. A skin graft is often useful in the case of burns or small, superficial defects in the limbs.

Flap surgery is a procedure that entails the transfer of tissue and blood vessels from one area of the body to the wound to optimise and facilitate healing. This procedure is individualised to each patient and their reconstructive requirements.

RECOVERY

The recovery period is often lengthy and entails physical therapy and intense rehabilitation to prevent stiffness, increase strength and flexibility, and to achieve mobility. The eventual outcome is strongly influenced by associated comorbidities such as obesity, diabetes, smoking, and peripheral vascular disease.