Treatment for soft tissue defect combined with infection in the knee and upper leg used reverse anterolateral thigh flap or musculocutaneous flap.

Abstract

Objective To investigate the clinical effect of reverse anterolateral thigh flap with lateral superior genicular artery or musculocutaneous flap for treating soft tissue defect combined with infection in the knee and upper leg. Methods From March 2007 to March 2008, 11 patients with soft tissue defect combined with infection in the knee and upper leg were treated in our hospital. There were 8 males, 3 fe-males, with the mean age of 33.4 years (range, 23-65 years), left thigh for 7 patients and right thigh for 4 patients. The course of disease was ranged for 6 hours to 8 months. One patient was caused by a open injury leading to skin and soft tissue defect in the anteroinferior knee combined with the fracture of tibial plateau, and was treated with debridement, internal fixation and transferring flap; ten patients were caused by the chronics infection with skin and soft tissue defect, and were treated with transferring anterolateral thigh flap later after treating with anti-infection, debridement and drainage. The injury area ranged from 6.3 cm×3.0 cm to 12 cm×7 cm. Results All patients were followed up for 3 to 6 months, with the average 4.7 months. All the flaps kept alive after operation. Three cases were debrided again in the followed 1-2 weeks because of the unhealing borderline of the flaps. Nine cases were sutured without need for skin graft, 2 cases had partial skin graft. No infection and necrosis were found in all flaps and the flaps were all alive after 3 months fol-low-up. The knee joints of all patients had a good motion. Conclusion The soft tissue defect combined with infection in the knee and upper leg can be treated with reverse anterolateral thigh flap, after controlling in-fection successfully. The flaps were thin and easy to alive, the musculocutaneous flaps can obturate the space and anti-infection. This method can reduce the operative trauma especially without need for the skin graft and get a good effect. Key words: Surgical flaps; Soft tissue injuries; Infection