Browse > Article

Reconstruction of Lower Extremity Soft Tissue Defect Using Cross-leg Free Flap  

Lee, Jung-Hun (Department of Plastic and Reconstructive Surgery, Kyungpook National University)
Yang, Jung-Dug (Department of Plastic and Reconstructive Surgery, Kyungpook National University)
Lee, Sang-Youn (Department of Plastic and Reconstructive Surgery, Kyungpook National University)
Chung, Ho-Yun (Department of Plastic and Reconstructive Surgery, Kyungpook National University)
Cho, Byoung-Chae (Department of Plastic and Reconstructive Surgery, Kyungpook National University)
Publication Information
Archives of Plastic Surgery / v.36, no.5, 2009 , pp. 591-596 More about this Journal
Abstract
Purpose: To reconstruct soft tissue defect on lower extremity especially combined with osteomyelitis, free flap with enough blood supplies is required. There are some instance when patients have inadequate recipient vessels for microanastomosis. Anastomosis with harvested vein graft can solve the problem. It may be more problematic or even increase recipient site complication. Cross leg free flaps using contra - lateral vessel can be a solution. Methods: From 2005 to 2008, 12 cases of cross leg free flap were done for 12 patients(male = 9, female = 3). External fixators used in all cases. Free flaps used were laissmus dorsi muscle flap(n=5), anterolateral thigh flap(n=4), gracilis muscle flap(n=2) and medial plantar artery fasciotaneous flap(n=1). In all cases, contralateral posterior tibial artery and vein were used as recipient pedicle. Results: All flaps survived without additional operative procedures. There were no complications such as hematoma or Infection. Sometimes patients needs further therapeutic exercise for fast movement recovery. Conclusion: Although cross leg free flaps require long period of bed resting and rehabilitation after pedicle cutting, It can be practical alternative for soft tissue defect on lower distal extremity with inadequate recipient vessels for free flap on affected leg.
Keywords
cross-leg free flap;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Pollack WJ, Parkes JC 3nd: Technical details in the management of cross-leg flaps. J Trauma 10: 663, 1970   DOI   PUBMED
2 Stevenson TR, Mathes SJ: Management of foot injuries with free-muscle flaps. Plast Reconst Sur   DOI   ScienceOn
3 Mathes SJ, Alpert BS, Chang N: Use of the muscle flaps in chronic osteomyelitis: experimental and clinical correlation. Plast Reconst Surg 69: 815, 1982   DOI   PUBMED   ScienceOn
4 Daniel RK, Tayo GI: Distant transfer of an island flap by microvasular anastomosis. Plast Reconstr Surg 52: 111, 1973   DOI   ScienceOn
5 Tsur H, Daniller A, Strauch B: Neovascularization of skin flaps: route and timing. Plast Reconstr Surg 66: 85, 1980   DOI   PUBMED   ScienceOn
6 Calderon W, Chang N, Mathes SJ: Comparison of the effect of bacterial inoculation in musculocutaneous and fasciocutaneous flap. Plast Reconstr Surg 77: 785, 1986   DOI   ScienceOn
7 Chen HC, Mosely LH, Tang YB, Wei FC, Noordhoff MS: Difficult reconstruction of an extensive injury in the lower extremity with a large cross-leg microvascular composite- tissue flap containing fibula. Plast Reconstr Surg 83: 723, 1989   DOI   PUBMED   ScienceOn
8 Russell RC, Graham DR, Feller AM, Zook EG, Mathur A: Experimental evaluation of the antibiotic carrying capacity of a muscle flap in to a fibrotic cavity. Plast Reconstr Surg 81: 162, 1988   DOI   PUBMED   ScienceOn
9 Khoo CT, Bailey BN: The behaviour of free muscle and musculocutaneous flaps after early loss of axial blood supply. Br J Plast Surg 35: 43, 1982   DOI   ScienceOn
10 Stark RB: The cross-leg flap procedure. Plast Reconstr Surg 9: 173, 1952   DOI
11 Guba AM Jr, Callahan J: Nutrient blood flow in delayed axial pattern skin flap in pigs. Plast Reconstr Surg 64: 372, 1979   DOI   PUBMED   ScienceOn
12 Long CD, Granick MS, Solomon MP: The cross-leg flap revisited. Ann Plast Surg 30: 560, 1993   DOI   PUBMED   ScienceOn