The repair of soft tissue defects in the lower leg. A comparison of different flap techniques.

The results following reconstruction of soft tissue defects in the lower leg in 102 patients with 19 cross-leg flaps, 49 muscle flaps, 17 dorsalis pedis island flaps and 26 free composite island flaps were compared regarding the pattern of primary healing, time taken to heal and costs. The cross-leg flap appeared to be the least dependable method of reconstruction and most expensive way of reestablishing stable soft tissue coverage. Muscle flaps and dorsalis pedis island flaps appeared to be preferable and equal alternatives to cross-leg flaps in the proximal and distal part of the lower leg, respectively. Free composite island flaps also appeared advantageous compared to cross-leg flaps, and seem to be indicated when simpler means of reconstruction are inadequate or would yield a similar result at higher overall costs.