The free flap man: An heroic 50-year odyssey via multiple flaps.

Most lower extremity challenges can be solved by a solitary free flap. Yet if multiple wounds exist in a single extremity, or if bilateral extremities are involved, then multiple free flaps by necessity may be required to preserve ambulatory capabilities. Even rarer is their need in a sequential fashion. Thus is the uniqueness of this steelworker who at the young age of 23 sustained bilateral foot and ankle molten steel immersion injuries, initially salvaged by skin grafts virtually directly on bone. Over the next 50 years there were repeated episodes of graft instability that required five different free flaps to provide stable soft tissue coverage. Amputation was avoided, allowing minimal interruption at work as a bus driver until retirement. This patient's long journey was only possible due to the virtue of persistence, proving the value of that trait inherent within the true microvascular surgeon. It should be no wonder that appropriately this is the "free flap man."