Answer:
This retrospective study reviews the outcome of patients with failed free flaps to lower extremities. The failure rate was 10 percent. The most common cause of failure was venous thrombosis (34 percent). There was an amputation rate of 22 percent versus 5 percent for non-flap failure. The other patients had salvage of their extremities by split-thickness skin graft, local flaps, or a second free flap. In addition there was a 35 percent rate of intermittent wound breakdown. The authors concluded that despite an initial free-flap loss, the majority of extremities can be salvaged with subsequent procedures but with a large percentage continuing to have wound problems.