[Preventing lower limb amputations in @entity1 suffering from XXXX and peripheral vascular disease - opportunities and limitations].

@entity1 @entity154 @entity6 @entity1912 @entity177 @entity1167 @entity121
BACKGROUND: The number of @entity1 suffering from a @entity6 is increasing. In many cases @entity154 can only be reconstructed by using a free @entity1912 . The free parascapular @entity1912 is an alternative to free @entity121 in the reconstruction of plantar or heel defects. Donor site morbidity is low. Autologous bypass reconstruction or an angioplasty can increase extremity perfusion. @entity1 AND OPERATIONS: 52 @entity1 with a @entity6 have been reconstructed since 2007. 23 of them required a free tissue transfer. On average these @entity1 were 68.7 years of age. A parascapular @entity1912 was used in 15 cases, a latissimus dorsi @entity1912 with a skin graft in 4 cases, a gracilis muscle @entity1912 with a skin graft in 3 cases. In one case a free instep @entity1912 of the contralateral foot, which had to be amputated, was used. In 13 cases the @entity1912 was anastomosed to the autologous bypass, in one case an AV loop was used. RESULTS: 22 flaps healed primarily. Only 1 @entity1 was not able to walk at discharge. There was one @entity1912 loss. 4 @entity1 required an amputation later on due to bypass @entity177 . 2 @entity1 died due to @entity1167 at the rehabilitation clinic. CONCLUSION: If the correct indication is met, free flaps can prevent @entity6 -derived amputations of the lower limb. The parascapular @entity1912 can be used for plantar and heel defects. @entity1912 harvesting is quick due to the constant vascular anatomy. The donor site morbidity is low. Reconstruction requires revascularisation in an interdisciplinary setting including vascular surgeons and radiologists. Limb salvage reduces mortality and improves quality of life. Revascularisation and reconstruction should best be done in a single surgical procedure.
