A literature search focusing on flap knee reconstruction revealed much controversy regarding the optimal management of around the knee defects. Muscle flaps are the preferred option, mainly in infected wounds. Perfora...A literature search focusing on flap knee reconstruction revealed much controversy regarding the optimal management of around the knee defects. Muscle flaps are the preferred option, mainly in infected wounds. Perforator flaps have recently been introduced in knee coverage with significant advantages due to low donor morbidity and long pedicles with wide arc of rotation. In the case of free flap the choice of recipient vessels is the key point to the reconstruction. Taking the published experience into account, a reconstructive algorithm is proposed according to the size and location of the wound, the presence of infection and/or 3-dimensional defect.展开更多
This report describes the procedure of a case in which the skin paddle of the free fibula flap derived its supply solely from a soleal musculocutaneous perforator originating from the posterior tibial system.In contra...This report describes the procedure of a case in which the skin paddle of the free fibula flap derived its supply solely from a soleal musculocutaneous perforator originating from the posterior tibial system.In contrast,the osteo-muscular component was supplied by the peroneal vascular system.We harvested the skin paddle with its vascular supply from the posterior tibial artery separately,and the osteo-muscular fibula was harvested with its supply from peroneal vessels.In this way,we avoided violation of the second donor site for the skin paddle.In addition,we used the distal end of peroneal vessels to salvage our skin paddle instead of sacrificing another set of neck vessels for anastomosis.This technique may also be utilised in cases where the neck vessels may not be available due to previous surgeries,radiation therapy,or decision by the surgery team to not sacrifice two sets of neck vessels for anastomosis.展开更多
文摘A literature search focusing on flap knee reconstruction revealed much controversy regarding the optimal management of around the knee defects. Muscle flaps are the preferred option, mainly in infected wounds. Perforator flaps have recently been introduced in knee coverage with significant advantages due to low donor morbidity and long pedicles with wide arc of rotation. In the case of free flap the choice of recipient vessels is the key point to the reconstruction. Taking the published experience into account, a reconstructive algorithm is proposed according to the size and location of the wound, the presence of infection and/or 3-dimensional defect.
文摘This report describes the procedure of a case in which the skin paddle of the free fibula flap derived its supply solely from a soleal musculocutaneous perforator originating from the posterior tibial system.In contrast,the osteo-muscular component was supplied by the peroneal vascular system.We harvested the skin paddle with its vascular supply from the posterior tibial artery separately,and the osteo-muscular fibula was harvested with its supply from peroneal vessels.In this way,we avoided violation of the second donor site for the skin paddle.In addition,we used the distal end of peroneal vessels to salvage our skin paddle instead of sacrificing another set of neck vessels for anastomosis.This technique may also be utilised in cases where the neck vessels may not be available due to previous surgeries,radiation therapy,or decision by the surgery team to not sacrifice two sets of neck vessels for anastomosis.
