Cross-bridge free skin flap transfer: case report.

Area of Science:

• Plastic Surgery
• Vascular Surgery
• Reconstructive Surgery

Background:

• Massive skin and soft tissue defects often present challenges in reconstructive surgery, particularly when accompanied by extensive vascular injury.
• The absence or unsuitability of recipient site vessels complicates the transfer of free flaps, a common reconstructive method.

Observation:

• A novel surgical procedure is described utilizing two donor components: a free skin flap and a vascular donor.
• These components are integrated to form a single unit, with the free flap covering the defect and its pedicle connected to a pedicled flap from a healthy limb.

Findings:

• The technique establishes a temporary cross-over vascular supply to the free flap by performing end-to-end anastomoses within a connecting skin bridge.
• This allows for successful free flap transfer even in scenarios with compromised or absent recipient site vasculature.

Implications:

• This procedure offers a viable solution for complex reconstructive challenges involving extensive tissue defects and vascular compromise.
• It expands the reconstructive armamentarium for plastic and vascular surgeons dealing with challenging cases.
• The technique potentially improves outcomes for patients requiring free flap reconstruction when traditional recipient vessels are not an option.