Use of the Medial Side of the Knee Skin as a Free Flap: Saphenous Flap

Abstract

The knee region is a good free skin flap donor site, as it has minimal subcutaneous tissue and provides a hidden donor site. Acland et al. first used the skin over the medial side of the knee as a "saphenous flap" based on the saphenous branch of the descending genicular artery. The authors studied the descending genicular artery and its saphenous branch in six cadaver limbs and elevated the skin over the medial side of the knee as a free flap in six patients to reconstruct lower extremity defects. In all clinical cases, the authors were able to elevate a skin flap from the skin on the medial side of the knee. The saphenous branch was absent in one cadaveric limb and one patient limb; instead, a direct cutaneous branch from the femoral artery reached the skin and had nearly the same caliber as the saphenous branch of the other cases. All the flaps survived and the defects healed well. The medial side of the knee is a good donor site, as it provides thin skin with innervation potential by means of the medial femoral cutaneous nerve and leaves an inconspicuous donor-site scar.