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 knee.
Patients 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.