The 2004 Annual Meeting (January 14-20, 2004) of OASYS_NEW

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Subatmospheric Pressure Therapy (VAC) as an Adjunct or Replacement to Free Tissue Transfer in Lower Extremity Reconstruction

Lee CK1, Song DH2, and Lohman RF2. (1) Plastic & Reconstructive Surgery, University of California at San Francisco (UCSF), 2250 Hayes Street, Suite 508, San Francisco, CA, USA, (2) Plastic & Reconstructive Surgery, University of Chicago, 5841 S Maryland Ave MC 6035, Chicago, IL, USA

Purpose Statement: We present a retrospective review of six patients who underwent successful VAC therapy as an adjunct to failed free tissue transfer, or as a replacement to free tissue transfer in lower extremity salvage.

Materials and Methods: Between March 2002 to November 2002, 6 patients were identified meeting the above criteria. Age, indications for free tissue transfer, wound type, time on VAC therapy to successful soft tissue coverage, time to ambulatory activities, and complications were parameters analyzed. These data are compared to a comparable successful free tissue.

Results: Patient age ranged from 6 to 65. Indications for free tissue transfer included exposed tendon, bone, or neurovascular structures secondary to trauma, tumor ablation, infection, and burn. Average time on VAC therapy was 22 days. Average time to ambulation was 30 days. There was 100% lower extremity salvage and no complications from VAC therapy.

Conclusion: VAC therapy and skin graft can serve as an adjunct to failed free tissue transfer for lower extremity reconstruction and can also serve as a replacement to free tissue transfer in those patients who are not candidates; this may force us to reconsider classic indications for free tissue transfer.


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