We examined cases of severe lower limb open fracture in which soft tissue was reconstructed by free or pedicled flaps at Nagasaki University Hospital Trauma Center. The cases were divided into two groups: a group in which soft tissue reconstruction was performed within 72 hours (early group) and the other in which it was performed after 72 hours (late group) . There were 8 cases in Early group and 23 in the late group. There was no significant difference in partial flap necrosis, total flap necrosis, postoperative infection, postoperative pneumonia, nonunion or inpatient days. However, deep vein thrombosis was slightly more frequent in the early group. Blood coagulation may have been accelerated by the surgical intervention shortly after severe trauma. A future challenge at our center is to accurately determine whether the limb salvage procedure should be performed for severe lower limb fractures in cases of polytrauma at an early stage of injury.
