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Deldar et al. Plast Aesthet Res 2022;9:13 https://dx.doi.org/10.20517/2347-9264.2021.100 Page 13 of 16

Figure 14. Calcified flap and recipient arteries. Calcified descending branch of the lateral circumflex artery (top of photo) and posterior
tibial artery. Satinsky clamps were used to attain proximal and distal control on the artery. Calcifications are seen in the lumen of both
arteries.

flaps are viable options for small defects that are within reach. Free flaps have become a mainstay in LE
reconstruction with high rates of flap success and long-term limb salvage. Preoperative optimization, a
multidisciplinary team approach, and adequate postoperative care are crucial. FTT reconstruction is not
“one size fits all”; careful consideration of patient comorbidities, donor site morbidity, and functional and
aesthetic outcome are of utmost importance when choosing flap type.

DECLARATIONS
Authors’ contributions
Designed and wrote majority of the manuscript: Deldar R
Contributed to writing manuscript: Merle C
Edited the manuscript: Attinger CE
Provided main conceptual design of manuscript and edited the manuscript: Evans KK

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
The study was approved by institutional review board. IRB Study 0007611 entitled “MedStar Plastic
Reconstructive Surgery Outcomes Registry” was approved by MedStar Health Research Institute.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2022.