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Zhang et al. Plast Aesthet Res 2019;6:30 I http://dx.doi.org/10.20517/2347-9264.2019.040 Page 9 of 11

reconstruction has become increasingly available for injuries previously thought to be unsalvageable. The
pre-existing dogma advocating for immediate soft-tissue reconstruction within a 72-h window has since
been liberalized in the setting of improved wound-care, the widespread use of negative pressure wound
therapy, and the advent of damage-control orthopedic surgery, allowing reconstruction of increasingly
complex injuries in severely sick patients. The improved understanding of perfosomes and refinement
of microsurgical technique have facilitated the paradigm of the reconstructive elevator to more closely
approximate pre-morbid anatomy and function. The use of ancillary imaging including CTA, angiography,
and doppler ultrasound has refined the identification and characterization of recipient vessels for free-
tissue transfers. As technological advances continue to augment preoperative assessment, routine wound
care, and intraoperative planning, reconstruction will continue to more closely approximate pre-injury
functionality, improving patient outcomes and satisfaction.

DECLARATIONS
Authors’ contributions
Share conceptualization and authorship of this review: Zhang AY, Cholok D, Lee GK
Made substantial contributions in editing the manuscript: Lee GK

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2019.

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