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Othman et al. Plast Aesthet Res 2022;9:29 Plastic and
DOI: 10.20517/2347-9264.2021.135
Aesthetic Research

Review Open Access

Soft-tissue management and reconstruction of
lower-extremity trauma

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Sammy Othman , Saïd C. Azoury , Kevin M. Klifto , L. Scott Levin , Stephen J. Kovach 5
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Department of Plastic and Reconstructive Surgery, Northwell Health, New York, NY 1075, USA.
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Division of Plastic and Reconstructive Surgery, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
1075, USA.
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Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Missouri, Columbia, MO 65211, USA.
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Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA.
Correspondence to: Dr. Sammy Othman, Department of Plastic and Reconstructive Surgery, Northwell Health, 2000 Marcus
Ave New Hyde Park, New York, NY 1075, USA. E-mail: Sothman@northwell.edu; sothman13@gmail.com
How to cite this article: Othman S, Azoury SC, Klifto KM, Levin LS, Kovach SJ. Soft-tissue management and reconstruction of
lower-extremity trauma. Plast Aesthet Res 2022;9:29. https://dx.doi.org/10.20517/2347-9264.2021.135
Received: 19 Dec 2021 First Decision: 15 Feb 2022 Revised: 15 Feb 2022 Accepted: 24 Feb 2022 Published: 9 Apr 2022
Academic Editor: Matthew L Iorio Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Soft-tissue management and subsequent salvage of the lower extremity following trauma has long presented
difficult challenges to the plastic surgeon. Trauma to the lower extremity can produce long-term sequelae
consisting of psychological trauma, functional deficits, and increased costs to the healthcare system. Avoiding
incorrect management is important, and is compounded by the fact that few guidelines exist on appropriate
treatment and patient counseling. This study aims to describe the authors’ experience at a large limb salvage
center in order to further delineate management strategies.
Keywords: Reconstructive surgery, trauma, lower extremity, microsurgery, soft-tissue

INTRODUCTION
Composite lower extremity reconstruction has long presented delicate challenges to surgeons and requires a
comprehensive multidisciplinary approach. Defects, most often secondary to trauma and oncology,
necessitate appropriate diagnostic strategies and timely interventions if limb salvage is to be successful. The

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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