Arch Reconstr Microsurg.  2014 Nov;23(2):70-75. 10.15596/ARMS.2014.23.2.70.

Soft Tissue Reconstruction Using Perforator Flap in Patients with Infected Knee Prosthesis

• Lee JW
• Kim SH
• Yoo JH
• Roh SG
• Lee NH
• Yang KM

• KMID: 1917841
• DOI: http://doi.org/10.15596/ARMS.2014.23.2.70

Abstract

PURPOSE
Soft-tissue reconstruction in the knee area requires thin, pliable, and tough skin. The range of motion of the knee also acts as a limitation in using only local flaps for coverage. The author has successfully used various perforator flaps for soft tissue reconstruction around the knee while preserving its functional and cosmetic characteristics.
MATERIALS AND METHODS
Out of the twenty patients assessed from April 2009 to March 2011, seven received anterolateral thigh perforator flaps, four received medial sural perforator island flaps, four received lateral supragenicular perforaor perforator flaps, and five received medial genicular artery flaps. The age of the patients ranged from 44 to 79 and the size of the defects ranged from 4x5 cm to 17x11 cm. Fifteen of the twenty patients had histories of total knee replacement (TKR) surgery.
RESULTS
There were no flap losses in any of the twenty patients assessed. Two patients showed partial losses in the distal area of the flap, but were treated through careful wound care. One patient presented with pedicle adhesion at the drainage site from a past TKR, but it did not hinder the flap survival. Primary closure at the donor site was possible in nine patients, while split skin graft was necessary for the other 13.
CONCLUSION
In soft tissue reconstruction of the knee, various perforator flaps can be used depending on the condition of the preoperation scar, wound site, and size. It also proved to provide better functional and cosmetic results than in primary wound closure or skin grafts.

Keyword

Reconstructive surgical procedures; Perforator flap; Knee prosthesis

MeSH Terms

Arteries
Arthroplasty, Replacement, Knee
Cicatrix
Drainage
Humans
Knee
Knee Prosthesis*
Perforator Flap*
Range of Motion, Articular
Reconstructive Surgical Procedures
Skin
Surgical Flaps
Thigh
Tissue Donors
Transplants
Wounds and Injuries