Cutaneous angiosome of the chimeric SLGA perforator flap: Anatomical study and clinical considerations

Gstoettner, Clemens; Mayer, Johannes A.; Aman, Martin; Salminger, Stefan; Bürger, Heinz; Hirtler, Lena; Weninger, Wolfgang J.

doi:10.1016/j.bjps.2019.02.016

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…The prior medial thigh incision and lateral genicular incision from the previous procedure made all the other fascio‐cutaneous flap options inappropriate (proximally based medial saphenous flap, lower medial thigh perforator flap, superior lateral genicular perforator flap, and medial genicular artery perforator flap). (Gstoettner et al, 2019; Mohan et al, 2019; Scaglioni et al, 2020) The position of the defect could allow the use of a peroneal perforator flap but this option appeared unreliable in the context of impaired vascularization. (Ruan et al, 2010) No proper ALT or AMT perforators were found.The possibility of using a free flap was initially ruled out due to the prior vascular bypasses.…”

Section: Discussionmentioning

confidence: 99%

“…Fasciocutaneous perforator flaps present the advantages of less morbidity, and better pliability, and cosmetic outcomes (Gravvanis et al, 2014;Ruan et al, 2010;Scaglioni et al, 2020;Wiedner et al, 2011;Zheng et al, 2015). Many authors recommend the medial sural artery perforator flap (MSAP) in particular(Gstoettner et al, 2019;Ling et al, 2018). Reverse ALT perforator flaps and Reverse Anteromedial Thigh (AMT) perforator flaps are the leading options currently used to reconstruct extensive defects around the knee (Demirseren et al, 2011;Lin et al, 2016;Zhu et al, 2018).…”

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confidence: 99%

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“Reverse tensor fascia latae perforator flap for reconstruction of knee defect: Anatomic study by computed tomographic angiography and a case report”

et al. 2022

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Background Reverse anterolateral thigh perforator (ALTp) pedicle flap can be used to reconstruct perigenicular defect thanks to the anastomoses between the descending branch of the lateral circumflex femoral artery (LCFA) and the perigenicular network. In a few cases, however, patients do not present any ALTp. We hypothesized that, in such cases, an adjacent perforator, the tensor fascia latae perforator (TFLp), emerging from the LCFA ascending branch, could be used instead. To assess the feasibility of this technique, a radiological study was conducted. A first patient was treated using this option. Methods Sixty lower limb computed tomography were analyzed. The first treated patient was a 50‐years‐old man suffering from a 5‐mm chronic bone exposure and osteomyelitis. Other reconstructive options were not indicated since he presented a multiscarry leg, severe arteriopathy, and no ALTp. A TFLp flap was raised, and the LCFA ascending and descending branches were dissected in continuity. After ligation of the LCFA, the blood flow reversed in the descending branch to irrigate the flap through the ascending branch. Results A TFL perforator was observed in all the cases of the radiological study. The LCFA branching pattern was compatible with achieving a reverse TFL perforator flap in 43 cases (72%). The average pedicle length was 32 cm (22–38 cm). In the first clinical case, the flap covered the defect easily. After three months, the patient showed no evidence of infection recurrence and recovered a painless walk. Conclusion The reverse TFLp flap can be a suitable option for perigenicular reconstruction.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

“Reverse tensor fascia latae perforator flap for reconstruction of knee defect: Anatomic study by computed tomographic angiography and a case report”

et al. 2022

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“…2 ). Gstoettner et al [ 9 ] showed a constant SLGA angiosome with a mean size of 222.8 cm 2 over the anterolateral proximal knee joint.…”

Section: Introductionmentioning

confidence: 99%

“…A review of the literature was conducted utilizing PubMed, with the keywords “superior,” “lateral,” “genicular,” and “artery.” Twelve articles pertaining to the use of the SLGA flap were identified: two cadaveric studies 8 9 , four combined cadaveric studies and case series 3 5 6 7 , three case series 1 10 11 and three case reports 12 13 14 . Data pertaining to anatomy, patient characteristics, etiology, surgical details, and complications were compiled and the results were summarized ( Tables 1 Tables 2 3 ).…”

Section: Introductionmentioning

confidence: 99%

The superior lateral genicular artery flap for reconstruction of knee and proximal leg defects

et al. 2022

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Reconstruction of defects around the knee region requires thin and pliable skin. The superior lateral genicular artery (SLGA) flap provides an excellent alternative to muscle-based flaps. The anatomy and the surgical techniques of the SLGA flap were reviewed and the results of cases using the SLGA flap for coverage of knee and proximal leg defects were analyzed. SLGA flaps were performed in two cases and followed up for at least 6 months. Twelve articles on the use of the SLGA flap were also identified. A review of 39 cases showed that the mean diameter of the perforator supplying the skin of the flap was 1.04 mm, while the mean diameter of the SLGA at its origin was 1.78 mm. The mean length of the pedicle measured from the origin of the popliteal artery was 7.44 cm. The average dimensions of the flap were 14.8×6.6 cm with primary closure of the donor site in 61.5% of cases. Of these cases, 38.5% were due to trauma, 23.1% were post-burn complications, 12.8% were defects after resection of tumors, and 10.3% were for ulcers post-bursectomy. The most common complication was flap tip necrosis. All studies reported favorable outcomes with complete wound healing.

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Treatment of Kienböck’s Disease Using Free Vascularized Cartilage Bone Flaps from the Lateral Femoral Condyle

Anoshina

Higgins

Jiga

et al. 2022

Clinical Scenarios in Reconstructive Microsurgery

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Cutaneous angiosome of the chimeric SLGA perforator flap: Anatomical study and clinical considerations

Cited by 7 publications

References 21 publications

“Reverse tensor fascia latae perforator flap for reconstruction of knee defect: Anatomic study by computed tomographic angiography and a case report”

“Reverse tensor fascia latae perforator flap for reconstruction of knee defect: Anatomic study by computed tomographic angiography and a case report”

The superior lateral genicular artery flap for reconstruction of knee and proximal leg defects

Treatment of Kienböck’s Disease Using Free Vascularized Cartilage Bone Flaps from the Lateral Femoral Condyle

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