Cross‐leg tibial posterior perforator flap

Background: In the lower leg posttraumatic pathology, we are frequently confronted with tissue defects that are difficult to cover by local or distance means, because of either the poor tissue quality or the precarious local vessels. One of the still available methods for solving these cases remains the cross‐leg flap. The authors will try to demonstrate the advantages of this method, by using the cross‐leg flap based on perforator vessels. Methods: We are presenting two cases for which we practiced a cross‐leg perforator flap, based on perforator vessels emerging from the posterior tibial artery. Results: The results were favorable, demonstrated by immobilization in a comfortable position, perfect flap integration, pedicle flap's division at 14–21 days, early postsurgery ambulation. Conclusions: The cross‐leg perforator flap diminishes many of the disadvantages created by the classic cross‐leg flap and can be successfully used in cases in which other procedures are prohibited. © 2007 Wiley‐Liss, Inc. Microsurgery, 2007.

[1]  T. Ozaki,et al.  Posterior tibial adiposal flap for repair of wide, full-thickness defect of the Achilles tendon. , 2005, Journal of reconstructive microsurgery.

[2]  M. Itoman,et al.  "Slipper-like avulsion injury" of the foot: a report of two rare cases salvaged by conventional cross-leg flaps. , 2005, The Journal of trauma.

[3]  A. Gözü,et al.  Use of Distally Pedicled Sural Fasciocutaneous Cross-Leg Flap in Severe Foot and Ankle Trauma: A Safe Alternative to Microsurgery in Very Young Children , 2005, Annals of plastic surgery.

[4]  G. Hallock.  Medial suralGASTROCNEMIUS muscle perforator free flap: an immediate cross-leg flap? , 2005, Journal of reconstructive microsurgery.

[5]  R. Musharafieh,et al.  Distally based sural fasciocutaneous cross-leg flap: a new application of an old procedure. , 2003, Plastic and Reconstructive Surgery.

[6]  A. Georgescu,et al.  Emergency free flaps , 2003, Microsurgery.

[7]  A. Ay.  An unusual contracture of the foot caused by a neglected burn wound salvaged by a cross-leg flap. , 2002, Plastic and reconstructive surgery.

[8]  Luis Eduardo Bermú Dez,et al.  Experimental model of facial transplant. , 2002, Plastic and reconstructive surgery.

[9]  A. Schwabegger,et al.  Thoracodorsal artery perforator (TAP) flap: report of our experience and review of the literature. , 2002, British journal of plastic surgery.

[10]  Hung-Chi Chen,et al.  Have We Found an Ideal Soft‐Tissue Flap? An Experience with 672 Anterolateral Thigh Flaps , 2002, Plastic and reconstructive surgery.

[11]  P. Beau,et al.  [Anterolateral thigh flap for limb reconstructive surgery: four case reports]. , 2002, Revue de chirurgie orthopedique et reparatrice de l'appareil moteur.

[12]  S. Yıldırım,et al.  Use of Distally Based Saphenous Neurofasciocutaneous and Musculofasciocutaneous Cross-Leg Flaps in Limb Salvage , 2001, Annals of plastic surgery.

[13]  F. Martı́nez-Soriano,et al.  The Medial Sural Artery Perforator Free Flap , 2001, Plastic and reconstructive surgery.

[14]  A. Elkwood.  Techniques of Face Lift , 2001 .

[15]  M. Al-Qattan.  A Modified Technique for Harvesting the Reverse Sural Artery Flap From the Upper Part of the Leg: Inclusion of a Gastrocnemius Muscle “Cuff” Around the Sural Pedicle , 2001, Annals of plastic surgery.

[16]  C. Quarmby,et al.  The distally based, cross-leg, sural artery island flap. , 2001, Plastic and reconstructive surgery.

[17]  S. Jeng,et al.  Free Anterolateral Thigh Flap for Extremity Reconstruction: Clinical Experience and Functional Assessment of Donor Site , 2001, Plastic and reconstructive surgery.

[18]  M. Topalan,et al.  Cross-leg free flap for emergency extremity salvage: case report. , 2001, Journal of reconstructive microsurgery.

[19]  N. Niranjan,et al.  Fascial feeder and perforator-based V-Y advancement flaps in the reconstruction of lower limb defects. , 2000, British journal of plastic surgery.

[20]  A. Koutselinis,et al.  The Inferiorly Based Gastrocnemius Muscle Flap: Anatomic Aspects , 2000, Plastic and reconstructive surgery.

[21]  A. Schwabegger,et al.  Limb salvage after fulminant septicemia using a free latissimus dorsi cross-leg flap. , 2000, Journal of reconstructive microsurgery.

[22]  G. Verna,et al.  The Distally Based Superficial Sural Flap: Our Experience in Reconstructing the Lower Leg and Foot , 2000, Annals of plastic surgery.

[23]  D. Mohan,et al.  Perforator based V-Y advancement flaps in the leg. , 1998, British journal of plastic surgery.

[24]  Shaw Ad,et al.  The island posterior calf fasciocutaneous flap: an alternative to the gastrocnemius muscle for cover of knee and tibial defects. , 1998 .

[25]  M. Granick,et al.  The cross-leg flap revisited. , 1993, Annals of plastic surgery.

[26]  V. Lees,et al.  Use of a pedicled fascial flap based on septocutaneous perforators of the posterior tibial artery for repair of distal lower limb defects. , 1992, British journal of plastic surgery.

[27]  C. Carriquiry.  Heel coverage with a deepithelialized distally based fasciocutaneous flap. , 1990, Plastic and reconstructive surgery.

[28]  C. Gerber,et al.  The lateral supramalleolar flap. , 1988, Plastic and reconstructive surgery.

[29]  S. Berson,et al.  The distally based split soleus muscle flap. , 1987, British journal of plastic surgery.

[30]  A. Masquelet,et al.  [The vascularized cross-leg flap]. , 1985, Presse medicale.

[31]  D. Mears,et al.  The role of free-tissue transfers in lower-extremity reconstruction. , 1985, Plastic and reconstructive surgery.

[32]  A. Bashir.  Inferiorly-based gastrocnemius muscle flap in the treatment of war wounds of the middle and lower third of the leg. , 1983, British journal of plastic surgery.

[33]  B. Pontén.  The fasciocutaneous flap: its use in soft tissue defects of the lower leg. , 1981, British journal of plastic surgery.

[34]  A. Morris,et al.  The place of the cross-leg flap in reconstructive surgery of the lower leg and foot: a review of 165 cases. , 1978, British journal of plastic surgery.

[35]  N. Georgiade,et al.  Comparison of free flaps with pedicled flaps for coverage of defects of the leg or foot. , 1977, Plastic and reconstructive surgery.