Flap Decisions and Options in Soft Tissue Coverage of the Lower Limb

Daniel J Jordan 1, Marco Malahias 2, Sandip Hindocha*, 1, Ali Juma 3
1 Department of Plastic Surgery, Whiston Hospital, Liverpool, UK L35 5DR, UK
2 Department of Plastic Surgery, Heart of England NHS Foundation Trust, UK
3 Department of Plastic Surgery, Countess of Chester Hospital, Chester, UK

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© Jordan et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Department of Plastic Surgery, Whiston Hospital, Liverpool, UK L35 5DR, UK; Tel: + 44(0)1244366265; Fax: +44(0)1244366265; E-mail:


The lower extremities of the human body are more commonly known as the human legs, incorporating: the foot, the lower or anatomical leg, the thigh and the hip or gluteal region.

The human lower limb plays a simpler role than that of the upper limb. Whereas the arm allows interaction of the surrounding environment, the legs’ primary goals are support and to allow upright ambulation. Essentially, this means that reconstruction of the leg is less complex than that required in restoring functionality of the upper limb. In terms of reconstruction, the primary goals are based on the preservation of life and limb, and the restoration of form and function. This paper aims to review current and past thoughts on reconstruction of the lower limb, discussing in particular the options in terms of soft tissue coverage.

This paper does not aim to review the emergency management of open fractures, or the therapy alternatives to chronic wounds or malignancies of the lower limb, but purely assess the requirements that should be reviewed on reconstructing a defect of the lower limb.

A summary of flap options are considered, with literature support, in regard to donor and recipient region, particularly as flap coverage is regarded as the cornerstone of soft tissue coverage of the lower limb.

Keywords: Flap, lower limb, reconstruction..