Is Flap Reconstruction Right for Your Chronic Leg Wound?

For many Americans, the critical ability to heal is compromised thanks to vascular issues associated with common conditions like diabetes and peripheral artery disease (PAD), which collectively affect more than 50 million people.

As a result, any small wound in the lower extremities is cause for big concern as infection and amputation become clear and present dangers.

As experts in the fields of diabetic foot ulcers and chronic lower leg wounds, the team at Foot Ankle Leg Wound Care Orange County is your first stop. Under the direction of double board-certified wound specialist Dr. Thomas Rambacher, we routinely help patients to navigate potentially dangerous leg wounds and one of our go-to tools is flap reconstruction surgery. 

Here’s a look at how we can get healing of a chronic leg wound to go in the right direction with flap reconstruction.

Why healing is so important

It might seem obvious, but we want to quickly touch on why chronic wounds are so dangerous. Under normal circumstances, your body is protected by its largest organ: your skin. And your skin does a fantastic job of shielding you from all the visible and invisible threats.

When you have a chronic wound, it means that your circulation is compromised and healing resources, namely oxygenated blood and immune cells, struggle to get to the site. As a result, wound healing stalls and the skin barrier is left open, allowing harmful bacteria to invade and create a dangerous infection.

To give you an idea about the seriousness of this threat, let’s look at diabetic ulcers, which develop in about 1.6 million Americans each year. About one-third of these wounds fail to heal, 65% recur within five years, and 85% of these wounds precede partial or complete amputation of the lower limb.

Our goal is to disrupt this chain of events and to promote healing, which is where the flap reconstruction comes in.

Shoring up your skin barrier with flap reconstruction

When you have a chronic leg wound, it means that bacteria have had ample time to damage your tissues. And this damage can surpass your body’s already compromised ability to heal. In other words, your skin barrier can become permanently disabled, which sets the stage for even bigger problems, such as infections that raid your bones.

With flap reconstruction, our goal is to reestablish your skin barrier. To do this, we harvest a healthy piece of skin from elsewhere in your body and we place it over the chronic leg wound.

With flap reconstruction, the skin graft is more than just skin. We take care to find a piece of healthy skin with good vascularization, which is critical to success. Since your chronic wound stems from poor blood flow, it makes sense to introduce healthier blood vessels to the area.

3 types of flap reconstruction

When it comes to finding the right piece of tissue to use for your flap reconstruction, there are three possibilities:

1. Local flap

Under the best circumstances, we can use a piece of neighboring skin and flip it over to cover the chronic wound in your leg. This allows us to keep the blood vessels intact and attached to existing skin.

2. Regional flap

With this flap reconstruction, we use a piece of skin that’s not adjacent, but nearby. With a regional flap, we can keep some blood vessels attached.

3. Microvascular free flap

If we need to harvest healthy skin from elsewhere in your body, Dr. Rambacher performs a flap reconstruction in which he attaches the blood vessels to existing ones via microsurgery.

Whichever type of flap reconstruction we choose, the goal is the same, to provide healthy tissue that will help keep your skin barrier intact and infection at bay. And we’ve had great success using flap reconstruction to put an end to chronic lower leg wounds.

The best way to figure out whether flap reconstruction surgery can play a role in getting your chronic wound to heal is to call our office in Mission Viejo, California, at 949-832-6018 or request an appointment online today.