Abstract
Background: Numerous techniques were reported for knee soft tissue defect reconstruction. Regional flap with epidural anesthesia could be considered if patient's underlying disease could not bear general anesthesia. Aim and Objectives: Epidural anesthesia instead of general anesthesia reduced high pulmonary morbidity in patients with pulmonary disease. Besides, epidural anesthesia can attenuate the surgical stress response, increase lower extremity blood flow associated with sympathectomy, and improve pain control. Materials and Methods: This 55 year old male has chronic obstruction pulmonary disease (COPD) with the problem of traumatic hemopneumothorax and soft tissue defect over medial side of left knee. Defect was resurfacing by medial sural artery perforator (MSAP) island pedicle flap under epidural anesthesia. Results: The MSAP island pedicle flap provides durable skin and thin soft-tissue coverage with good aesthetic result in four months follow up. Conclusion: The MSAP island pedicle flap could be an alternative choice in regional reconstruction, especially when patient's condition is not suitable for general anesthesia.
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