Cross-Leg Free Flaps for Difficult Cases of Leg Defects

Chen, Hung-Chi; El‐Gammal, Tarek Abdalla; Wei, Fu‐Chan; Chen, Hern-hsin; Noordhoff, M. Samuel; Tang, Yueh‐Bih

doi:10.1097/00005373-199709000-00016

Cited by 55 publications

(54 citation statements)

References 9 publications

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“…[1][2][3] Various types of microvascular anastomoses can be used depending on the flaps and the recipient sites: end-to-end, 4,5 end-to-side, 6,7 flow-through 8 and retrograde. 9,10 Of these, end-to-end and end-to-side anastomoses are the most commonly used.…”

mentioning

confidence: 99%

Comparative Study of Different Combinations of Microvascular Anastomosis Types in a Rat Vasospasm Model: Versatility of End-to-Side Venous Anastomosis in Free Tissue Transfer for Extremity Reconstruction

Miyamoto

Takushima

Okazaki

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

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mentioning

confidence: 99%

Comparative Study of Different Combinations of Microvascular Anastomosis Types in a Rat Vasospasm Model: Versatility of End-to-Side Venous Anastomosis in Free Tissue Transfer for Extremity Reconstruction

Miyamoto

Takushima

Okazaki

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…Hence, the cross-leg flap becomes a valuable option in the aforementioned conditions. Significant donor site deformity and morbidity, long operative hours, and secondary revision for debulking and contouring of the flap specially used around heel and ankle may be considered as additional disadvantages with free tissue transfer [6][7][8][9].…”

Section: Resultsmentioning

confidence: 99%

Cross-Leg Flap: Its Reliability and Outcome

Shoeib¹

2013

MPS

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Background: Cross-leg flaps for lower limb wound coverage have been replaced by free tissue transfer in the last two decades. However, there are certain difficult situations where the free flap cannot be employed and alternative methods are needed. We describe our experience with cross-leg flap in 135 patients for the reconstruction of difficult leg defects in which no possible other options available for reconstruction of the defect. Materials and Methods: This study was carried upon one hundred thirty five patients suffering from leg and/or foot soft tissue injury. This study focused on the cases that need coverage of bone, tendons, and neurovascular bundle, while those that managed by local flap or split thickness graft were excluded. Results: All patients ambulate well after 5 -10 days, except for 14 patients who had associated orthopedic problems as external fixation, or other fractures. Cosmetic outcome were excellent in all patients, but 3 patient's mothers complaint of bulky flap, and for them liposuction was done with postoperative satisfaction. 2 cases complaint of early donnar sit graft, but later on they were satisfied. Conclusion: Cross-leg flap offers the possibility of salvaging limbs that are otherwise nonreconstructable.

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“…[2][3][4][5] But in these techniques, multiple stages are needed thus nullifying the advantage of single stage reconstruction in free flap.…”

Section: Discussionmentioning

confidence: 99%

Cross leg flaps: are they relevant in the present era?

2017

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Background: Injuries of lower limb due to road traffic accidents are challenging to reconstruct due to paucity of tissues and damage to vasculature. Recurrent trophic ulcers are also difficult to reconstruct due to stigmata of previous surgeries. When local and regional flaps are not available, free flaps become the best option. The success of free flap depends on the presence of healthy recipient vessels and microsurgical expertise. In cases where the free flaps have failed or when there is no available soft tissue for local flaps, cross leg flaps are a method of resurfacing and salvaging the limb.Methods: This Study was done from January 2013 to January 2016 in Rajiv Gandhi Government General Hospital, Chennai. 20 patients were included in the study and the flaps used were conventional cross leg and cross leg reverse superficial sural artery flap.Results: All flaps survived. There was one case of wound dehiscence managed by re-insetting, two cases with marginal necrosis which were managed conservatively. One case of partial loss which was managed by STSG and one case of sinus formation due to tuberculosis managed with ATT. Remaining flaps had no complications.Conclusions: Cross leg flaps are still relevant in the present era of microsurgery. They can be the primary choice of reconstruction or as a workhorse when free flaps have failed or other loco regional flaps are already exhausted. Immobilisation and two stage reconstruction are few disadvantages which when weighed against limb salvage are acceptable.

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Cross-Leg Free Flaps for Difficult Cases of Leg Defects

Cited by 55 publications

References 9 publications

Comparative Study of Different Combinations of Microvascular Anastomosis Types in a Rat Vasospasm Model: Versatility of End-to-Side Venous Anastomosis in Free Tissue Transfer for Extremity Reconstruction

Comparative Study of Different Combinations of Microvascular Anastomosis Types in a Rat Vasospasm Model: Versatility of End-to-Side Venous Anastomosis in Free Tissue Transfer for Extremity Reconstruction

Cross-Leg Flap: Its Reliability and Outcome

Cross leg flaps: are they relevant in the present era?

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