Inferiorly based thigh flap for reconstruction of defects around the knee joint

Abstract

Background:Soft-tissue defects around the knees are common in injured limbs and in the same injury the leg is often involved and the thigh is spared. Furthermore due to pliable and relatively lax skin, we have used inferiorly based thigh flap to reconstruct defects around knee joint.Aims and Objectives:The aim of this study is to evaluate the use of inferiorly based thigh flap to cover soft-tissue defects over the proximal one-third of the leg, patellar region, knee, and lower thigh.Materials and Methods:This study was conducted during the period between October 2011 and February 2013. Inferiorly based anteromedial thigh fasciocutaneous flap was performed on 12 patients and inferiorly based anterolateral thigh fasciocutaneous flap on four patients. The sites of the soft-tissue defects included patellar regions, infrapatellar region, upper one-third of leg, lower thigh, and over the knee joint.Results:Patients were evaluated post-operatively in terms of viability of flap, the matching of the flap with the recipient site, and donor site morbidity. All the flaps survived well except one which developed distal marginal flap loss, one in which wound dehiscence was noticed, and two in which mild venous congestion was observed. Venous congestion in two patients subsided on its own within 3 days. One patient with wound dehiscence achieved complete healing by secondary intention. Patient who developed distal flap loss required debridement and skin grafting. No appreciable donor site morbidity was encountered. Skin colour and texture of the flap matched well with the recipient site.Conclusions:The inferiorly based thigh flap is a reliable flap to cover the defect over proximal one-third of the leg, patellar region, knee, and lower thigh.

Diabetic foot infections: what have we learned in the last 30 years?

“…107 Contrary to previous beliefs, soft tissue coverage by skin grafting or flaps is possible if needed, even in ischemic areas. 108…”

Lower medial thigh perforator (LMTP) propeller flap for reconstruction of soft tissue defects around the knee

“…For the management of lateral and suprapatellar defects, fasciocutaneous flaps from both the leg and the thigh have been harvested (Akhtar et al, ; Osei et al, ; Shim & Kim, ). According to a recent literature, among the pedicled perforator flap employed for the upper leg reconstruction, the distally based or reverse‐flow anterolateral thigh (ALT) flap and the MSAP flap provide the best coverage, despite that other flaps are valuable options (Wong et al, ).…”

“…The standard of knee reconstruction is still argued; historically defects around the knee and in the upper third of lower extremity have been reconstructed by local muscle flaps (A. Gravvanis et al, ). However, different options including local cutaneous flaps, pedicled perforator‐based fasciocutaneous and free flaps are available in the current literature (Akhtar, Khan, Khurram, & Ahmad, ; Demirseren, Efendioglu, Demiralp, Kilicarslan, & Akkaya, ; H. P. Zheng et al, ). The lower medial thigh (LMT) perforator flap has been described by the senior author (M.F.S.)…”

“…Gravvanis et al, 2014). However, different options including local cutaneous flaps, pedicled perforator-based fasciocutaneous and free flaps are available in the current literature (Akhtar, Khan, Khurram, & Ahmad, 2014;Demirseren, Efendioglu, Demiralp, Kilicarslan, & Akkaya, 2011; H. P. Zheng et al, 2012). The lower medial thigh (LMT) perforator flap has been described by the senior author (M.F.S.)…”

Extraordinary Bauschinger effect in gradient structured copper

“…Strain hardening is the primary approach for improving ductility [11]. There are two mechanisms to produce strain hardening in metals, i.e., forest dislocation hardening and back stress hardening [12][13][14][15]. The forest dislocation hardening is attributed to the accumulation of dislocations.…”