Free flap reconstruction for trauma in the early post-partum period

We present the case of a patient who suffered significant polytrauma, fracturing her pelvis, femur and tibia and requiring emergency caesarian section of her 36-week old foetus. Forty eight hours later she underwent free flap reconstruction of her open tibial fracture. The issues involved in performing free flap surgery in the early postpartum period and specific surgical and pharmacological measures taken to overcome the physiological hypercoagulable state of post-partum patients are described along with a summary of the literature.