Microsurgery, 2011. “
“Introduction: Microsurgical lower extremity flap reconstruction provides a valuable option for soft tissue reconstruction in comorbid patients. Limb salvage with flap reconstruction can result in limb length preservation. Despite this, few Selleck AZD2281 studies have examined the impact of salvage on patient-centered metrics in this cohort of patients. Therefore, we investigated quality of life and patient satisfaction following microsurgical

lower extremity reconstruction in this high-risk patient population. Factors that resulted in improved patient-centered outcomes were also identified. Methods: A retrospective review was conducted of all patients who had lower R788 supplier extremity free flap reconstruction (FFR) following lower extremity wounds. High-risk patients were identified as having multiple comorbidities and chronic wounds. Patients with traumatic wounds were excluded from analysis. Quality of life was evaluated with the Short Form-12 (SF-12) validated survey. Phone interviews were conducted for survey evaluations. Results: From 2005 to 2010, 57 patients had lower extremity flap reconstruction that met the inclusion criteria. Average follow-up was 236.6 weeks (range, 111–461). Comorbidities included diabetes (36%),

PVD (24.6%), and ESRD (7%). Limb length preservation and ambulation occurred in 82.5% (47/57). Revisional surgery occurred in 33.3% (19/57). Survey response rate was 63%. Average SF-12 PCS and MCS scores were 44.9 and 59.8 for patients able to achieve ambulation and 27.6 and 61.2 for nonambulatory patients. Conclusions: Microsurgical flap reconstruction is a valuable reconstructive

option in high-risk patients. Quality of life is comparable with Cell press a normalized population if limb salvage is successful. Quality of life is decreased significantly when failure to ambulate occurs in this patient cohort. © 2013 Wiley Periodicals, Inc. Microsurgery 34:1–4, 2014. Lower extremity reconstruction with the aim toward limb salvage in the co-morbid patient population is a difficult undertaking for the reconstructive surgeon. Co-morbidities such as diabetes mellitus, peripheral vascular disease, and renal failure add complexity to microsurgical reconstruction. Systemic vascular changes such as recipient vessel disease, recipient site scarring, and donor vessel disease may pose a technical challenge. However, successful outcomes in lower extremity reconstruction are well demonstrated in this patient population and provide patients with the option of limb salvage.[1, 2] Early successful outcomes are predicated by overcoming compromised vascular inflow and by controlling infection. Following the early postoperative period, achieving successful long-term outcomes becomes more challenging. Traditionally flap survival was the marker for defining a successful outcome.