ABSTRACT
The authors present a procedure that can be used in cases of massive skin and soft tissue defect accompanied by extensive vascular injury. The technique involves the use of two donor components (a free skin flap and a vascular donor) which form a single unit postoperatively. The free flap is stretched over crossed limbs, with its major lateral portion serving to cover the defect, and the margin of its medial portion containing the flap pedicle sutured to a pedicled skin flap from the healthy contralateral limb. End-to-end anastomoses of vessels from both components are performed within the skin bridge that connects the crossed limbs. A temporary cross-over vascular supply to the free flap from vessels of the healthy limb is thus created. The procedure is offered as a satisfactory solution to the problem of transferring free flaps in cases where recipient site vessels are absent or unusable.
