Reconstructive plastic procedures in primary care and in postprimary/secondary treatment following below knee and above knee amputation are discussed. Short amputation stumps and stumps suffering from insufficient soft tissue coverage should be primarily avoided employing salvage replantation techniques. Secondarily conventional flaps and grafts, tissue expansion and/or microsurgical free tissue transfer all serve for achieving stable skin conditions and preserve adequate stump lengths. Interdisciplinary treatment racionale will lead to improvement of functional and social rehabilitation.