Versatility Of The Superior Lateral Genicular Artery Perforator Flap For Coverage Of Soft Tissue Defects Around The Knee

Abstract

Background: Coverage of soft tissue defects around the knee is a reconstructive challenge. The superior lateral genicular artery perforator (SLGAp) flap provides an excellent alternative to muscle and musclocutaneous flaps with less morbidity, for coverage of these defects, especially when the gastrocnemius muscle flap is not available. The vascular basis of this flap, SLGA perforators, have consistent and reliable anatomy.Aim of The Study: This study is a retrospective analysis of our clinical experience with the superior lateral genicular artery perforator flap for coverage of soft tissue defects of the kneePatients and methods: This study was done at The Department of Plastic and Reconstructive Surgery, Menofia University Hospitals, from January 2017 to November 2018, with follow up period of 12 months. It included 7 patients, 6 males, and 1 female, with their age ranged from 19 to 46 years. The around-knee defects were due to different etiologies, 1 patient due to shotgun, 1 patient with post-burn contracture of the lateral popliteal fossa, and 5 patients with traffic accidents. The defects were reconstructed by the superior lateral genicular artery perforator (SLGAp) flap.Results: all flaps survived, except in 2 cases, 1 case managed conservatively and healed well, and in the second, the necrotic part was debrided and skin grafted. The donor site was closed primarily in 2 cases and skin grafted in 5 cases. Skin graft take was perfect, except in 3 cases with minor patches of graft loss and healed spontaneously. Infection around the defect site occurred in 2 cases and managed conservatively. The flap provided stable and durable coverage with minimal donor site morbidity and no functional loss.Conclusion: The superior lateral genicular artery perforator flap is a versatile option for reconstruction of soft tissue defects around the knee or popliteal fossa. The anatomy of the flap perforators is consistent and reliable. The flap is thin, pliable and provides stable coverage with adequate match of the surroundings. Donor site morbidity is minimal with no functional loss.Key Words: Superior lateral genicular artery_ Knee defects_ perforator flap.