Role of Reconstructive Surgery in War and Civilian Trauma

Abstract

There were many problems in covering soft-tissue defects, especially in the lower extremities, before the introduction of free flaps. After the introduction of the free flap in 1972, these problems were more or less solved; however, there were still some defects which could not be covered easily by conventional free flaps, such as long bone defects and extensive soft tissue loss. In civilian trauma, debridment and flap transfer may be efficacious, but in war wounds, which are usually caused by high-velocity missiles, the treatment by free flaps and nerve injury are different. As high velocity agents create damage to vessels proximally and distally, anastomosis should not be performed near the zone of injury.