title: Operation Iraqi freedom: A report on a series of soldiers treated with free tissue transfer by a plastic surgery service.
abstract: Free flaps in combat wounds are predisposed to failure. Few reports are available on their use in American military combat wounds. We present our experience with free flaps during Operation Iraqi Freedom. This is a retrospective review of soldiers treated by plastic surgeons at Brooke Army Medical Center. Eight free flaps were for soft tissue coverage in which local tissue was not available. Causes of the wounds: 2 from a rocket-propelled grenade, 4 from explosive devices, 1 from a fall, and 1 from a helicopter crash. Indications for the flaps were 2 exposed calvaria, 3 lower-extremity fractures, 2 upper-extremity wounds, and 1 exposed Achilles tendon. Four latissimus dorsi muscle flaps and 4 radial forearm fasciocutaneous flaps were used. All flaps were successful. Three flap-related complications required operative intervention. Free flaps can be used successfully in combat wounds, with minimal morbidity, and should be considered in American soldiers with complex wounds.
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA. Deowallchattar@yahoo.com
authors.forename: Deowall
authors.initials: D
authors.lastname: Chattar-Cora
authors.forename: Roberto
authors.initials: R
authors.lastname: Perez-Nieves
authors.forename: Alexander
authors.initials: A
authors.lastname: McKinlay
authors.forename: Markian
authors.initials: M
authors.lastname: Kunasz
authors.forename: Richard
authors.initials: R
authors.lastname: Delaney
authors.forename: Robert
authors.initials: R
authors.lastname: Lyons
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000601:surgery*; D005597:Fractures, Open / Q000601:surgery*; D005610:Freedom; D006801:Humans; D007493:Iraq; D008297:Male; D008866:Microsurgery; D008889:Military Personnel; D009104:Multiple Trauma / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps; D016378:Tissue Transplantation; D014481:United States; D014857:Warfare