Lower extremity reconstruction is an essential part of plastic surgery and focuses on the treatment of injuries and defects caused by trauma, cancer, or chronic disease processes. Over the past 25 years, advances in plastic surgery techniques such as free tissue transfer and more advanced wound care technologies have revolutionized the field, allowing limbs that would otherwise have been amputated to be saved.

The goal of lower extremity reconstruction is to protect/cover open leg defects and wounds to heal the patient’s wound and allow them to resume life, mobility, and return to work, while simultaneously avoiding amputation. Defects and open wounds in the lower extremity are caused by trauma, tumor resection, and chronic diseases such as peripheral vascular disease and diabetes; these wounds need reconstruction for several reasons.

First, any exposed bone that is not covered by vascularized soft tissue is at risk for osteomyelitis, bone necrosis, and sepsis. Osteomyelitis is mostly due to amputation in patients after leg trauma, or in patients with systemic diseases, mainly diabetes. Second, open wounds lead to chronic pain, inability to move freely, significant medical bills, and unemployment. Exposed tendons begin to dry out and become necrotic, and exposed blood vessels are at risk of rupturing.