This article briefly summarizes the techniques for repair of skin and soft tissue defects around the knee joints as reported in 5 papers in this issue, including how to choose the skin flap, muscle flap, myocutaneous flap, and vascular anastomosis in recipient site. It is found that the anterolateral femoral flap, latissimus dorsi myocutaneous flap, and gastrocnemius flap are widely used in clinic with high survival rates, and they can be used for the repair of large soft tissue defects as well as the reconstruction of the knee joint function.
Humans ; Knee Injuries ; surgery ; Knee Joint ; physiopathology ; surgery ; Muscle, Skeletal ; Myocutaneous Flap ; Reconstructive Surgical Procedures ; methods ; Skin ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Treatment Outcome ; Wound Healing

OBJECTIVETo investigate the clinical efficacy of free latissimus dorsi musculocutaneous flaps in repairing large and deep skin and soft tissue defects around the knee joints.

METHODSTwenty-five patients with large and deep skin and soft tissue defects around the knee joints were hospitalized from March 2005 to March 2014. The area of defects around the knee joints ranged from 10 cm × 8 cm to 43 cm × 23 cm. The free latissimus dorsi musculocutaneous flaps were used to repair the defects, with the area ranging from 12 cm × 10 cm to 45 cm × 25 cm. The thoracodorsal artery and its concomitant vein of the musculocutaneous flap were anastomosed to the descending branch of the lateral circumflex femoral artery and its concomitant vein respectively to reconstruct blood supply. Split-thickness skin grafts around the flap donor sites were harvested to cover the muscle surface of the musculocutaneous flaps. The flap donor sites were closed directly with suture, and the skin donor sites were healed by dressing change.

RESULTSAll the 25 flaps survived without vascular crisis. The flaps were in satisfactory appearance. The flap donor sites were healed with linear scar. All the patients were followed up for 3 to 6 months. At last, they were able to stand up and walk.

CONCLUSIONSThe free latissimus dorsi musculocutaneous flap transplantation is an effective treatment for the repair of large and deep soft tissue defects around the knee joints, and the descending branch of lateral circumflex femoral artery and its concomitant vein are the appropriate recipient vessels.

Cicatrix ; Humans ; Knee Joint ; Myocutaneous Flap ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Superficial Back Muscles ; Treatment Outcome ; Veins ; Wound Healing

OBJECTIVETo observe the effect of free lateral upper arm perforator flap in repairing wound on hand or foot due to electrical burn.

METHODSSix patients with full-thickness wounds on hand or foot resulting from electrical burn were hospitalized from June 2010 to June 2013. The wounds ranged from 6.0 cm ×4.0 cm to 8.5 cm×7.5 cm in area. Free lateral upper arm perforator flaps were used to repair these defects, with flap area ranging from 9 cm ×4 cm to 12 cm × 9 cm. The donor sites in five cases were closed by suturing; the other one donor site was closed by transplantation of full-thickness skin from abdomen.

RESULTSOne flap used to repair the wound in middle finger failed due to failure of venous return, and it was repaired with full-thickness skin harvested from abdomen after dressing change. The other five flaps survived resulting in good elasticity and matched appearance of the recipient area without obvious bulkiness. Patients were followed up for 6 to 24 months. The function of the injured hands or feet recovered well, and the results of function evaluation of five hands were excellent in 2 cases, good in 2 cases, and poor in 1 case. Little scar formation with no contraction or function impairment was observed on donor site, and the result was satisfactory.

CONCLUSIONSFree lateral upper arm perforator flap, with long vessel and less adipose tissue, is suitable for repairing small but deep wound on hand or foot due to electrical burn.

Adult ; Aged ; Arm ; surgery ; Burns, Electric ; surgery ; Foot Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Perforator Flap ; Skin Transplantation ; methods ; Young Adult