Distally Based Anterolateral thigh Pedicled Flap in the Reconstruction of Defect Around Knee.

Park, Sang Soon; Shim, Jeong Su

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(6):769-774.
Published online November 1, 2010.

Distally Based Anterolateral thigh Pedicled Flap in the Reconstruction of Defect Around Knee.

Sang Soon Park, Jeong Su Shim

Department of Plastic and Reconstructive Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea. 21csue@hanmail.net

Abstract

PURPOSE
As the soft tissue defect around the knee is difficult to reconstruct, local flap or free flap is used. Distally based anterolateral thigh pedicled flap introduced by Zhang uses sufficient reverse flow supplied from the vascular network around the knee. We report successful reconstruction of defect around knee by this method. METHODS: Four patients with skin & soft tissue defect around knee have been treated for reconstruction using the distally based anterolateral thigh pedicled flap. First, the doppler was used to check the perforator flap of the descending branch of the lateral circumflex femoral artery and to draw and dissect the perforator flap as much as needed. After the dissection, the proximal of the descending branch was clamped and checked for sufficient supply of blood flow from the reverse flow and then ligated. It was dissected along the descending branch and in order to prevent damage to the joined parts of the descending branch and the lateral superior geniculate artery, a more careful ligation was done starting from 10 cm superior to the knee. The defect was reconstructed after securing enough vascular pedicle to cover all the damaged parts.
RESULTS
Not all patients suffered from flap necrosis. In case of the patient with chronic osteomyelitis, slight venous congestion was observed right after the surgery but it disappeared the following day. All three patients had no occurences of additional complications.
CONCLUSION
Distally based anterolateral thigh pedicled flap was enough to provide large flap for knee reconstruction. It had sufficient blood flow and vascular pedicle. It also had taken short operation time compared to the free flap operation. The distally based anterolateral thigh pedicled flap used by the authors is a very useful way of reconstructing the area around knee.

Keywords: Distally based anterolateral thigh pedicled flap; Reconstruction around knee

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