Soft Tissue Reconstruction

Because of both large and small vessel diseases, patients with vascular problems and diabetes frequently present with wounds of the lower extremity. These problems can be challenging for both poor inflow through the large vessels and diseased competency of the microvasculature. A combined approach with collaboration between the vascular surgeon and the reconstructive surgeon will give the best chances for successesfully treating these patients. If there are issues with large vessel disease, these should be addressed first. Once adequate inflow has been established, the patient’s wound may be managed with any number of techniques. Microsurgical free tissue transfer remains a viable option in these patients. This paper will cover the approach to such patients and the techniques to improve success of these procedures.