Ibrahim Abdelrahman, Mohamed Farahat Sherif, Dahy Bassant, Shehata Abdelmesih Shenouda, Sahnon Abaker Sahnon Abdelrahman, Hamadelniel Alhadi Ibrahim Adil, Humida Ali Gorashi Gorashi, H J Alkhazendar Jarallah, Alkhazendar Aliaa H, Ahmad Shahzad
Trauma and Orthopedic, University Hospital of North Midlands NHS, Stoke-on-Trent, GBR.
General Surgery, Hywel Dda University Health Board, Wales, GBR.
Cureus. 2025 Jul 30;17(7):e89043. doi: 10.7759/cureus.89043. eCollection 2025 Jul.
Cross-leg flaps remain a vital reconstructive option in the management of complex lower limb injuries, particularly in settings where microsurgical techniques are unavailable or unaffordable. This systematic review evaluates the outcomes, indications, limitations, and success rates of cross-leg flap use in lower limb salvage within resource-limited settings. A comprehensive search of PubMed, Google Scholar, Scopus, ScienceDirect, and the Cochrane Library was conducted to identify studies published up to July 2025, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Seven studies encompassing a total of 726 patients were included, comprising case reports, case series, retrospective cohorts, and systematic reviews. Trauma was the most common indication for reconstruction, and fasciocutaneous flaps were the predominant type used. External fixators were frequently employed for limb immobilization, with the average time to pedicle division ranging from 20 to 62 days, depending on flap type. Flap survival rates were consistently high across all studies, ranging from 96% to 100%, with minimal reported complications. The review highlights that cross-leg flaps offer a simple, effective, and context-appropriate solution for limb salvage in low-resource environments. Despite limitations in study design and outcome reporting, the consistency of clinical success supports the continued use and teaching of cross-leg flap techniques in global reconstructive surgery. Further prospective studies are needed to standardize outcomes and refine protocols for broader application in underserved surgical systems.
交腿皮瓣仍然是复杂下肢损伤治疗中至关重要的重建选择，特别是在无法获得或负担不起显微外科技术的情况下。本系统评价评估了在资源有限的环境中使用交腿皮瓣进行下肢挽救的结果、适应证、局限性和成功率。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，对PubMed、谷歌学术、Scopus、ScienceDirect和Cochrane图书馆进行了全面检索，以识别截至2025年7月发表的研究。纳入了7项研究，共726例患者，包括病例报告、病例系列、回顾性队列研究和系统评价。创伤是重建最常见的适应证，筋膜皮瓣是主要使用的皮瓣类型。外固定器常用于肢体固定，根据皮瓣类型，蒂切断的平均时间为20至62天。所有研究中皮瓣存活率一直很高，范围从96%至100%，报告的并发症极少。该评价强调，交腿皮瓣为低资源环境中的肢体挽救提供了一种简单、有效且适合具体情况的解决方案。尽管研究设计和结果报告存在局限性，但临床成功的一致性支持在全球重建手术中继续使用和传授交腿皮瓣技术。需要进一步的前瞻性研究来规范结果并完善方案，以便在服务不足的外科系统中更广泛地应用。
