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This paper reviews how these principles came about and why they are important.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a structured review of historical and recent literature pertinent to lower limb reconstruction. The outcomes assessed in the pre\u2010modern era were wound mortality, amputation mortality and amputation rate. In the modern era, infection and non\u2010union emerged as measures of outcome, which are morbidity\u2010 rather than mortality\u2010based. Indications for amputation published during the eras are taken to reflect the reconstructive practices of the time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Amputation and wound mortality fell throughout the pre\u2010modern era, from 70% and 20% to 1.8% and 1.8%, respectively. Amputation rates peaked in the <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merican <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ivil <jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>ar (53%) but have remained less than 20% since then. Infection and non\u2010union rates in the modern era have fluctuated between 5% and 45%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Priority areas for research include refinement of soft tissue reconstruction, injury classification, standardization of outcome measures and primary prevention. The impact of d\u00e9bridement and antisepsis on outcomes should not be forgotten as progress is made.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1445-2197.2012.06271.x","type":"journal-article","created":{"date-parts":[[2012,9,19]],"date-time":"2012-09-19T04:38:37Z","timestamp":1348029517000},"page":"348-353","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["History of lower limb reconstruction after trauma"],"prefix":"10.1111","volume":"83","author":[{"given":"Michael","family":"Wagels","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Rowe","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shireen","family":"Senewiratne","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Theile","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,9,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)31536-4"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1998.tb04843.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181bf825e"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1006407"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)31544-3"},{"key":"e_1_2_6_7_1","first-page":"292","article-title":"The history of bone grafts","volume":"226","author":"Boer HH","year":"1988","journal-title":"Clin. 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