Greater Washington Plastic Surgery Associates | Vineet Mehan, MD, | Earl M. Johnson, Jr., MD,

Lower Extremity Reconstruction

leg reconstruction fairfax VA | Washington, DC

Leg and lower extremity injuries and conditions can be mildly irritating or severely debilitating. Whether mild or severe, they often inhibit a person’s ability to live his or her life fully. In some cases, a person may not be able to work, enjoy recreational activities, or get dressed or do other types of daily living activities.

When the injury or condition becomes severe, surgery may be the solution that can best restore function to the affected area and alleviate pain.

RECONSTRUCTIVE GOALS

  • Restore limb function and salvage limbs.
  • Cover vital structures.
  • Maintain a satisfactory appearance following injury, infection, chronic nonhealing wounds, vascular or metabolic disease, rheumatoid arthritis, and many other diseases and disorders.

REASONS FOR LOWER EXTREMITY RECONSTRUCTION 

  • Injury resulting in fractures and skin and tissue loss.
  • Exposed Orthopedic Hardware.
  • Infection.
  • Non-healing wounds after orthopedic and podiatric surgery.
  • Bone tumors.
  • Osteomyelitis.
  • Vascular or metabolic diseases.
  • Degenerative joint disease, rheumatoid arthritis.

LOWER EXTREMITY RECONSTRUCTION FAQS

 What are all of the treatments involved in lower extremity reconstruction?

There are a number of procedures involved in lower extremity reconstruction. It can be as simple as topical wound care treatments or as complicated as moving tissue from one part of the body to the lower extremity in what surgeons call a free flap or free tissue transfer. The first and most critical step in caring for lower extremity problems is thorough debridement or cleaning of the wound. Then based on the complexity of the problem further procedure may be needed. Patients that have orthopedic hardware exposed will need complex reconstruction.

 What is a skin graft?

A skin graft is a procedure where a thin piece of skin (10-16/1000th of an inch), is taken from one body part (usually the thigh) and transferred to another body part. It takes about 5 days for the skin graft to take and then it must be protected for an additional few weeks until it thickens.

 What is the healing process after a skin graft?

A skin graft is “healed” in about 5 days. At this point, it is still very fragile and needs to be protected with dressings. At this early stage, we will say, “the skin graft has taken to the wound.” The area where the skin was removed, the donor site, will take about 2 weeks to heal completely.

 What is a free flap reconstruction?

A free flap or free tissue transfer is the most complicated type of reconstruction. It is reserved for complicated wounds with exposed orthopedic hardware, exposed bone or other critical structure. In these cases, tissue (skin, fat, muscle, fascia) is harvested from one body part along with small blood vessels, one artery and at least one vein. The tissue is then “transplanted” to another body part and used to cover the exposed hardware. The artery and vein are connected to arteries and veins near the complex wound using microsurgical technique and often an operative microscope.

 When would an amputation be needed?

While every effort is made to save a limb, there are some cases where it is not possible. This could be from severe trauma or overwhelming infection. In these cases, an amputation is needed. Fortunately, prosthetic technology is rapidly progressing and patient with lower extremity prosthesis can lead normal lives and even run, and climb and maintain an active lifestyle.

Dominion Plastic Surgery offers leg reconstruction surgeries to patients living in Washington, DC, Bethesda and Potomac, MD, Falls Church, Arlington, and Alexandria, VA. Call  (703) 544-8971 or fill out a Contact Form here to schedule a consultation.