When Is It Time to Consider Flap Reconstruction?

Americans are hardly strangers to problematic lower leg wounds that struggle to heal. The issue affects 3-5% of people over the age of 65 and up to a third of people with diabetes. 

All too often these wounds lead to amputation, with about 80% of amputations in the United States being due to infected diabetic foot ulcers.

At Foot Ankle Leg Wound Care Orange County, our mission is to avoid this serious outcome and focus our efforts on foot and limb salvage instead. Under the expert guidance of double board-certified wound specialist Dr. Thomas Rambacher, our team has helped scores of patients to navigate chronic lower leg wounds without limb loss thanks in no small part to flap reconstruction.

Why some wounds don’t heal well

There are several conditions that can impede healing in your lower legs and most affect the circulation in and out of your legs, as well as your peripheral nerve health.

By the numbers, the driving forces behind lower leg wounds and chronic ulceration break out like this:

• Chronic venous insufficiency (CVI), which is responsible for 45-60% of chronic leg wounds
• Arterial insufficiency, which is responsible for 10-20% of the overall burden
• Diabetes, which accounts for 15-25% of lower leg ulcers

With these conditions, your ability to heal, especially in places that are far from your heart, like your lower legs, is compromised by poor circulation of healing resources. Without timely healing resources, infection can set in and spread, making limb loss a clear and present danger.

The important role of flap reconstruction

When you have a chronic lower leg wound, it struggles to close and heal over, which allows bacteria free reign to get inside, where they can create more damage.

To create a strong barrier against invading and harmful bacteria, we often turn to flap reconstruction, a technique in which we harvest healthy tissue from another part of your body and place it over the wound.

This donor tissue we use for flap reconstruction should have a healthy network of blood vessels, which will help ferry in healing resources.

Different types of flap reconstruction

Under ideal circumstances, we can use nearby tissue for the flap reconstruction, which allows us to keep the blood vessels intact. We simply flip the tissue over your wound.

If this isn’t possible, we can harvest healthy tissue from elsewhere, at which point Dr. Rambacher performs microsurgery to connect the blood vessels to make sure the tissue is viable.

When flap reconstruction is a good option

Now let’s look at when we turn to flap reconstruction to address a slow-healing lower leg wound.

When patients first come to us, we thoroughly evaluate the wound and its history to get a better idea about what we’re up against. In the early stages, we prefer to try more conservative options, such as strong antibiotics, debridement, and prescription wound care products.

If infection still sets in and spreads, and the wound shows no signs of healing, it’s time to discuss flap reconstruction. Infections in chronic wounds can wreak havoc in very little time so we need to act quickly to stop the spread and contain the infection. 

The good news is that you’re in excellent hands with Dr. Rambacher, who has considerable experience with flap reconstruction. This technique has helped many patients to avoid gangrene and limb loss by getting healing going in the right direction with new resources.

If you’d like to learn more about flap reconstruction and whether your lower leg wound can benefit from this innovative procedure, please call our office in Mission Viejo, California, at 949-832-6018 or request an appointment online today.