The authors presents the results of the early microsurgical reconstruction of complex trauma of the limbs. The patients aged ranged from 3 to 72 years, with the average 28.4 years. The wound size ranged from 12 to 840 cm2, with the average of 170 cm2. The treatment of the severely injured extremity upon admission to the trauma center is divided into three separate stages: debridement and stabilization; re-exploration of the wound and debridement within 48 hours; soft tissue coverage with free flaps is provided within one week. The numbers and kind of the free flaps are as follows: 2 plantar flaps, 8 gracilis muscle, 9 temporalis fascia, 15 latissimus dorsi, 16 lateral arm flaps, 24 rectus abdominis, 32 radial forearm flaps and 48 perforator free flaps. This study analyses the results obtained with the different flaps, their advantages, and try to find which factors influenced the survival rate. The statistical analysis showed that the magnitude of traumatic insult was the most significant factor associated with failure. Satisfactory results were achieved in 93% of the patients. Free flaps complications were low. The authors concluded that massive injuries to the extremities, regardless of the extent, should be managed by early aggressive debridement and early definitive reconstruction.
Keywords: Microsurgery, methods. Surgical flaps. Reconstructive surgical procedures, methods. Extremities