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The use of CobanTM compression bandage following below-knee free-flap surgery


Correspondence: Toby O. Smith, Faculty of Health, University of East Anglia, Norwich, Norfolk NR4 7UY, UK. Email:


The outcomes of Coban™ compression bandage in three cases following lower limb extremity free-flap surgery are reported. Two patients sustained open tibial fractures with extensive soft tissue loss, one case underwent a squamous cell carcinoma excision. Postoperatively, each patient commenced compression therapy on the lower limb prior to beginning mobilization, and continued for the first three postoperative months when mobilizing. No complications such as thrombosis, anastomosis failure, flap congestion, infection or healing issues were reported during the first six postoperative months, with 100% patient adherence to the compression bandage. Lower limb circumference measurements initially reduced in all cases, suggesting early effective oedema control. At the final 6 month review, two patients' circumference had increased when compared to baseline measurements attributed to an increase in muscle bulk at this late stage. The cosmetic appearance of the flaps at 6 months was acceptable in all cases, with no evidence of hypertrophic scarring.