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SKIN GRAFTING BY CROSS-LEG FLAPS

Fenton Braithwaite 1; and F. T. Moore 1

1 The Queen Victoria Hospital, East Grinstead, Sussex, England

1. After limb injuries with loss of skin and subcutaneous tissue, full-thickness skin flaps afford the most satisfactory cover. It is particularly important to replace unstable and scarred skin before attempting bone reconstruction and similar operations.

2. In the leg and foot, full-thickness skin cover is conveniently obtained by the cross-leg flap technique. The blood supply of such flaps is considered and the technique of operation is described. Free excision of avascular scar tissue is essential.

3. "Delayed transfer" of the flap is advisable unless conditions are favourable; two methods are considered.

4. Immobilisation in plaster is the most satisfactory method of fixation of the limbs after attachment of the flap. Muscle exercises are performed throughout the period of treatment in order to minimise joint stiffness and shorten convalescence.

5. The cross-leg flap technique should not usually be used in children, young women, or the aged and mentally infirm. Contra-indications include arthritis of the knee and hip joints because there is danger of joint stiffness.

6. Vascular complications of cross-leg skin grafting are discussed.
(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General