Treatment of Severe Leg Wounds With Muscle and Musculocutaneous Flaps

Zubowicz, Vincent N.; Coleman, John J.

doi:10.1001/archsurg.1984.01390200041010

Cited by 7 publications

(1 citation statement)

References 9 publications

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“…Local muscle flaps like gastrocnemius muscle flap on the other side are versatile and a valuable option for knee defects but at the expense of extensive dissection and donor-site deficits. 8–10 Free flap can provide all the sufficient tissue for reconstruction but at the expense of operative time, micro-vascular expertise, and recipient vessel choice. 11 Additional effort investigated the potential use of peroneal artery perforator or soleus perforator as recipient vessels.…”

Section: Discussionmentioning

confidence: 99%

Pedicled Peroneal Artery Perforator Flap for Knee Defect Reconstruction: Case Presentation and Literature Discussion

Alshomer

Alhujayri

Althubaiti

2018

Plastic and Reconstructive Surgery - Global Open

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Summary:There have been very limited data on the use of pedicled peroneal artery perforator flaps in knee soft-tissue reconstruction, especially for anterior and medial defects. Here, we present a case of proximally based peroneal artery perforator flap for knee soft-tissue reconstruction in a defect that included lateral, anterior, and medial surfaces of the knee presenting the technical challenges associated with this flap. A 15-year-old girl presented with extruded knee implant after osteosarcoma resection of femur. The defect involved the whole knee with the anterior and mostly the lateral knee surfaces. Her medical condition precluded the use of free tissue transfer. During her previous surgery, gastrocnemius muscles were detached with injured vascular pedicled and posterior tibial artery. Successful single-stage coverage was achieved using a large proximally based pedicled peroneal artery perforator flap. There are only few reports that described the use of peroneal artery flaps for knee soft-tissue coverage. The reach of a proximally based flap can be increased when it is raised on a distal perforator or when peroneal artery has a proximal takeoff. Furthermore, removing the fibula can facilitate the dissection and the reach of the flap till the most medial aspect of the knee. Pedicled peroneal artery perforator flap provides superior soft-tissue coverage with limited morbidity for knee soft-tissue reconstruction; however, flap reach is usually affected by anatomic variation. Preoperative planning can help to determine the reach of the flap and ease the dissection.

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Section: Discussionmentioning

confidence: 99%