Free tissue transfer is an essential component of lower extremity limb reconstruction and has dramatically improved salvage attempts. In this report, we examine the use of the underutilized free vastus lateralis muscle flap and describe our treatment protocol that involves a novel application for the vacuum-assisted closure device in an effort to reduce edema and congestion in lower extremity limb salvage. Thirteen patients underwent reconstruction with 14 vastus lateralis flaps with closure occurring on average 35.2 days after injury and an average case duration of 4:34 days. We report one flap failure, one superficial abscess, and one donor site hematoma. All patients were ambulatory at 6 months. Our early experience using this underutilized flap and novel protocol demonstrate successful lower extremity reconstruction with few complications, and good function and contour. Given its advantages, this versatile flap should be included as an option in lower extremity limb salvage operations.
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