Distally based extended peroneal artery septocutaneous perforator cross-bridge flap without microvascular anastomoses for reconstruction of contralateral leg and foot soft tissue defects.

A cross-leg or cross-bridge free flap is one of the choices for the reconstruction of serious leg soft tissue defects. Here, we report on six cases of leg and foot reconstruction with a distally based extended peroneal artery septocutaneous perforator cross-bridge flap without microvascular anastomoses. The vascular pedicle includes the peroneal artery, its perforator branch, and concomitant veins. The total pedicle length ranges from 10 to 14 cm, and the size ranges from 18 x 8 to 21 x 10 cm. All flaps survived completely without complications. Compared with a cross-leg or cross-bridge free flap, a distally based extended peroneal artery septocutaneous perforator cross-bridge flap without microvascular anastomoses does not require the use of some instruments or techniques for microsurgery, leading to a shorter operation duration and a lower risk of thrombosis in the vessel because microvascular anastomosis is not required.