Post-traumatic vessel disease (PTVD) is known to affect vessels well beyond the “zone of injury”. These vessels are often immersed in a thick fibrous atmosphere whose dissection frequently leads to refractory and irreversible spasm (IS). We examined 72 recipient vessels and incidences of IS in free flap surgery for fresh severe limb injuries. IS occurred in 8/72 (11.1 %) vessels if the flap surgeries were significantly delayed (p=0.047), regardless of their continuity especially in four lower limbs. If the outflow of the recipient vessels was poor after dissection and their spasms were irreversible, we have to anastomose more proximally or choose another vessel as the recipient.
