Skin grafts provide durable end-bearing coverage for lower-extremity amputations with critical soft tissue loss.

Lower-extremity amputations in the presence of soft tissue loss represent an unresolved conundrum because surgeons must consider sacrificing bone length to obtain adequate soft tissue coverage. Local flaps and microvascular soft tissue transfers are established strategies for maintaining residual limb length. However, the use of skin grafts remains controversial due to the presumed inferiority compared with flaps with regard to enabling prosthetic fitting and full weight bearing. The current study was designed to test the hypothesis that split-thickness skin grafts represent a safe and feasible option to preserve bone length in lower-extremity amputations with critical soft tissue loss.