Skin expansion for defective amputation stumps of the lower limb

Better procedures and materials have enabled us to improve the results of s kin expansion under knee level and extend its indications. We have used suc h procedures to cover defective amputation stumps in the lower extremity. W hen the local conditions are suitable, skin expansion permits the use of he althy skin from the lateral sides of the stump to provide coverage for the ulcerated areas, thus fulfilling the main goals which are to keep the bone shaft as long as possible and cover the stump with sensitive skin, so that a prosthesis can be fitted. In two cases, we also performed skin expansion at a distance to reduce the residual scar at the donnor site (expanded flap from the other leg, expande d full-thickness skin graft) when the amount of healthy skin available arou nd the stump was insufficient; the functional results were satisfactory. Skin expansion has become a choice strategy for this type of indication, bu t it must be performed perfectly to avoid complications or failures (our tw o first cases). It is important to take precautions at various stages of th e operation which must be carefully staged.