Evidence-Based Medicine: Management of Acute Lower Extremity Trauma

Abstract

Learning objectives: After studying this article, the participant should be able to: 1. Select and design flaps for the acutely injured lower limb based on wound location, size, and complexity. 2. Select and design tissue-specific flaps based on the functional demand of the zone of injury. 3. Understand the indications for using a flap with a skin component versus a muscle-only flap. 4. Understand the preoperative vascular assessment for lower extremity flap reconstruction. 5. Recognize and manage risk factors to decrease complications and improve flap survival.

Summary: The Maintenance of Certification series is designed to help the experienced surgeon structure the study of specific areas appropriate to his or her clinical practice. This article is designed to accompany practice-based evaluation of preoperative assessment, surgical treatment plan, and outcomes. In this format, he or she is invited to compare his or her methods with authoritative, information-based references. This information base is then used for self-assessment and benchmarking in Parts II and IV of the Maintenance of Certification process used by the American Board of Plastic Surgery. This article is not meant to be an exhaustive treatise on the subject, but rather designed to serve as a reference point for further in-depth study by review of the articles referenced. The goal of this article is to present evidence that may serve as practice-changing information. Furthermore, this article is designed with the recognition that participants may have different backgrounds, experience, expertise, and resources. The breadth of the topics discussed is designed to accommodate these differences.