Abstract
We read with great interest the article by Li and coworkers on posterior tibial artery (PTA) cross-bridge flaps.[1] Over a 1.5-year period, the authors performed distally based PTA cross-bridge flaps for coverage of contralateral leg soft tissue defects in nine patients. The flap described by the authors involved raising an island skin paddle based on the cutaneous perforators of the PTA and then dissecting the source vessel to gain length. Subsequently, the PTA is divided proximally, and the flap is transposed to cover the contralateral leg defect with the pedicle tunneled subcutaneously. Both the legs were next fixed in a “cross position” by an external fixator. The pedicles of all nine flaps were divided after a delay of 3 weeks. All flaps survived and provided stable cover for the contralateral leg. We compliment the authors for their extensive literature analysis and description of various advantages of the cross-bridge PTA flap as compared with a cross-bridge free flap. However, we would like to comment on certain issues.
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