Fasciocutaneous Flaps Based on Fascial Feeder and Perforator Vessels for Defects in the Patellar and Peripatellar Regions

Abstract

Soft-tissue reconstruction in the patellar and peripatellar regions is a challenging problem. Restoring the original thin, pliable, and tough skin properties is a necessary demand, if appearance and knee function are not to be compromised. Local tissue provides the closest match to the original, but limited availability can restrict the reach of conventional local flaps and, more often than not, produce donor sites that need coverage of their own. A retrospective study was performed over a 7-year period (from 1995 to September of 2002) using local fasciocutaneous flaps, based on fascial feeder and perforator vessels, to reconstruct a variety of patellar and peripatellar defects. Fifteen patients with a mean age of 62 years (range, 18 to 86 years) were reviewed. Early complications were minimal, with only one patient (wound dehiscence) requiring a further procedure. All patients achieved a good final outcome. The authors found the fascial feeder- and perforator-based local fasciocutaneous flap in the patellar and peripatellar regions to be a simple and reproducible technique to perform. By islanding local flaps on perforator/fascial feeder vessels, greater mobility is achievable, when compared with conventional flaps. Combining local fascial feeder- and perforator-based flaps with V-Y advancement minimizes donor-site complications. On this basis, well-matched local tissue can be used for reconstruction in the patellar and peripatellar areas, with minimal compromise to either appearance or function or both.