[Coverage of cutaneous loss of substance in the lower limb]

In the light of 10 years experience with more than 200 operative cases, the author presents the various operative techniques for the cover of skin loss in the lower limb. The different techniques are reviewed: muscle rotation flaps, myocutaneous flaps, pure cutaneous flaps, neurovascular island flaps and free vascular flaps. These procedures are described in detail, particularly those most often used. Indications are considered in terms of levels. At the present time, the author's preference is for muscle rotation or cutaneous flaps; his use of free vascular flaps has much diminished in recent years. The indications also depend on the patient's age, the condition of his joints and the state of his vessels.