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Upper and Lower Limb Reconstruction

Upper and Lower Limb Reconstruction - What is it for

Upper and Lower Limb Reconstruction - Symptoms

Upper and Lower Limb Reconstruction - How to prevent?

Upper and Lower Limb Reconstruction - Causes and Risk Factors

Upper and Lower Limb Reconstruction - Diagnosis

Upper and Lower Limb Reconstruction - Treatments

​Limb reconstruction refers to the repair and restoration of the skin, soft tissue and/or bone of the arms or legs. Such repairs may be required following:

  • Cancer surgery
  • Trauma
  • Infection

Limb reconstruction of wounds is crucial to preserve movement, function and prevent amputation.
 
The Procedure

Depending on the size of the wound and extent of injury to the rest of the limb, your reconstruction may involve:

  • Primary closure – moving the sides of the defect together
  • Free grafting – using skin or fascia from one part of the body to replace what is missing at the limb
  • Local flaps – movement of nearby tissues into the area that needs to be repaired
  • Free flaps –  transfer of skin, soft tissue, muscle and/or bone to replace what is missing at the limb. Because a large volume of tissue is moved from a faraway part of the body, the blood supply of the transferred unit (flap) has to be restored at the time of surgery by microscopic vascular repair.


After the Surgery

Dressings and/or bandages will be applied over the incisions. Small tubes (drains) will be placed to remove excess blood and fluid for at least several days. Painkillers and antibiotics will be prescribed to control the pain and minimize the risk of infection.

You will have to remain in the hospital for some time to monitor your wound, graft and/or flap to ensure that it heals well. Throughout your recovery period, a physiotherapist will attend to you regularly for regular breathing exercises and to help you get used to walking again. Following lower limb reconstruction, you may not be allowed to weight-bear for several weeks until your tissues and/or bones have healed. During this time, you will be taught how to get about with crutches or a wheelchair.

Recovering strength, range and movement of the affected limb can take months. If you still have extensive wound care or rehabilitation needs after a couple of weeks in hospital, you may be discharged with home nursing care or transferred to a community hospital.


Understanding the Risks

As with any major surgery, limb reconstruction carries risks such as:

  • Adverse reaction to the anaesthesia
  • Bleeding
  • Hematoma (accumulation of blood under the skin)
  • Seroma (an accumulation of fluid under the skin)
  • Damage to underlying important structures
  • Wound infection
  • Poor wound healing or wound breakdown
  • Poor scarring
  • Blood clots
  • Failure of the reconstruction, for example due to graft or flap loss
  • Permanent loss of range of movement or strength of the limb

You may need to undergo revision surgery to correct these problems. The subject of risks, as well as potential complications of surgery are best discussed on a personal basis between you and your plastic surgeon.

Upper and Lower Limb Reconstruction - Preparing for surgery

Upper and Lower Limb Reconstruction - Post-surgery care

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