Autologous tissue reconstruction for defect coverage of lower extremity wounds describes a broad interdisciplinary spectrum of conservative, surgical and interventional treatment options. The goals of reconstruction are a resilient and function-preserving but also esthetically acceptable wound closure, which should enable rehabilitation and the return to participation in social and working life for those affected. Depending on the wound conditions as well as on potentially occurring concomitant injuries and comorbidities, the timing and method of defect coverage is selected in an individualized approach for each patient. It is essential that the plastic surgeon is involved as early as possible in the preparation of a treatment plan and can then select the most appropriate and least invasive reconstructive procedure from the armamentarium, depending on the localization and etiology of the soft tissue defect. These vary from secondary wound closure to skin grafts up to local and free flaps.
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