We surveyed the details of salvage surgery to examine the causes of circulatory problems following free flap reconstruction for severe trauma in 63 limbs and identified measures to solve such problems. We assessed five patients (four men and one woman) who underwent salvage surgery for circulatory problems. The upper limbs were affected in two patients and lower limbs in three patients. Their mean age was 51.2 years (26?80 years) . The mean time from completion of surgery to entering the operating room to undergo salvage surgery was 19.6 h (6?36 h) . The vascular findings at the time of salvage surgery included arterial inflow failure (1 patient) , arterial thrombus (1 patient) , venous thrombosis (1 patient) , and venous compression on the flap side of the anastomosis (2 patients) , for which relevant treatment was administered. All flaps survived. When vascular problems are detected after free flap reconstruction for trauma of the limbs and managed early, the cause of the problems is identified and the success rate of salvage surgery is high.
