Perineal and lower extremity reconstruction

Scott T. Hollenbeck, Jason D. Toranto, Bruce J. Taylor, Trung Ho, Michael R. Zenn, Detlev Erdmann, L. Scott Levin

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Perform a preoperative assessment of patients undergoing perineal and lower extremity reconstruction. 2. Describe the various tissue flaps used to perform these reconstructions and the advantages and disadvantages of each. 3. Provide appropriate postoperative care and interventions to maximize outcomes. Background: The lower extremity and perineum provide the foundation for upright posture and ambulation. These areas are made up of intricate contours with variable skin types and must withstand the functional demands of organ orifice support and weight-bearing forces. Successful reconstruction calls for careful preoperative planning and consideration of the site-specific demands. MethodS: The authors reviewed literature regarding the most current treatment strategies for lower extremity and perineal reconstruction. Results: Perineal reconstruction is typically related to genitourinary or digestive tract abnormalities, mainly malignancies. Local and regional flaps are the mainstay of therapy, depending on their availability and the need for adjuvant therapy. Postoperatively, pressure reduction and closed-suction drainage are of major consideration. The lower extremities are prone to trauma, and these wounds often involve underlying and exposed bony abnormalities, and this must be considered in operative planning. Significant defects may be reconstructed with local or regional flaps and free-tissue transfer. The location of the wound and extent of surrounding tissue compromise are of major concern when determining flap coverage. Postoperatively, transition to ambulation and weight-bearing status is paramount. Conclusions: Reconstruction of the lower extremity and perineum requires recognition of the high functional demands of these areas. Local and regional flaps and free tissue transfer allow reconstruction of complex wounds in these areas. Selecting the correct flap and navigating the postoperative recovery to arrive at functional restoration remain a significant challenge.

Original languageEnglish (US)
JournalPlastic and Reconstructive Surgery
Volume128
Issue number5
DOIs
StatePublished - Nov 2011
Externally publishedYes

Fingerprint

Lower Extremity
Perineum
Free Tissue Flaps
Wounds and Injuries
Weight-Bearing
Walking
Postoperative Care
Suction
Posture
Gastrointestinal Tract
Reading
Therapeutics
Pressure
Skin
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Hollenbeck, S. T., Toranto, J. D., Taylor, B. J., Ho, T., Zenn, M. R., Erdmann, D., & Levin, L. S. (2011). Perineal and lower extremity reconstruction. Plastic and Reconstructive Surgery, 128(5). https://doi.org/10.1097/PRS.0b013e31822b6b87

Perineal and lower extremity reconstruction. / Hollenbeck, Scott T.; Toranto, Jason D.; Taylor, Bruce J.; Ho, Trung; Zenn, Michael R.; Erdmann, Detlev; Levin, L. Scott.

In: Plastic and Reconstructive Surgery, Vol. 128, No. 5, 11.2011.

Research output: Contribution to journalArticle

Hollenbeck, ST, Toranto, JD, Taylor, BJ, Ho, T, Zenn, MR, Erdmann, D & Levin, LS 2011, 'Perineal and lower extremity reconstruction', Plastic and Reconstructive Surgery, vol. 128, no. 5. https://doi.org/10.1097/PRS.0b013e31822b6b87
Hollenbeck ST, Toranto JD, Taylor BJ, Ho T, Zenn MR, Erdmann D et al. Perineal and lower extremity reconstruction. Plastic and Reconstructive Surgery. 2011 Nov;128(5). https://doi.org/10.1097/PRS.0b013e31822b6b87
Hollenbeck, Scott T. ; Toranto, Jason D. ; Taylor, Bruce J. ; Ho, Trung ; Zenn, Michael R. ; Erdmann, Detlev ; Levin, L. Scott. / Perineal and lower extremity reconstruction. In: Plastic and Reconstructive Surgery. 2011 ; Vol. 128, No. 5.
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