Repair of skin and soft tissue defects in extremities with the superior lateral genicular artery perforator flap_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 TANG Juyu , HE Jiqiang , WU Panfeng , ZHOU Zhengbing , YU Fang , QING Liming , PAN Ding , PANG Xiaoyang , ZENG Lei , XIAO Yongbing , LIU Rui

Department of Hand and Microsurgery, Xiangya Hospital, Central South University, Changsha Hunan, 410008, P.R.China;

Corresponding?author：

TANG Juyu, Email: tangjuyu@csu.edu.cn

Keywords：

Superior lateral genicular artery; perforator flap; extremity; wound repair

DOI：

10.7507/1002-1892.201811103

Video：

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Objective To investigate the feasibility and effectiveness of the superior lateral genicular artery perforator flap for repairing of soft tissue defects in extremities.Methods Between September 2010 and October 2017, 11 cases of skin and soft tissue in extremities were repaired with the superior lateral genicular artery perforator flap. There were 10 males and 1 female, with an average age of 37.6 years (range, 6-72 years). The causes of injury were traffic accident in 6 cases, machine injury in 1 case, falling down injury in 1 case, falling from height in 1 case, crushing injury in 1 case, and electric injury in 1 case. The defects located at the forearm in 1 case, knee in 5 cases, popliteal fossa in 2 cases, shank in 1 case, and foot and ankle in 2 cases. The area of the wound ranged from 8.0 cm×4.5 cm to 27.0 cm×8.0 cm. The interval from injury to admission was 6 days on average (range, 3-12 days). The area of perforator flap ranged from 9.0 cm×5.5 cm to 28.0 cm×9.0 cm. There were 8 cases of pedicle flap and 3 cases of free flap. All the donor sites were closed directly.Results Eight flaps survived without any complications and the donor sites healed by first intention. Two flaps had arterial crisis and 1 flap had venous crisis after operation, and the wounds healed after symptomatic treatment. There was no hematoma and secondary infections in all patients after operation. Ten patients were followed up 2-48 months (mean, 13.1 months). All flaps had satisfied appearance and texture. There was no motion limitations in the hip and knee joints of the operated legs.Conclusion The superior lateral genicular artery perforator flap not only can be used to repair the soft tissue defect around the knee joint as pedicle flap, but also can be used to repair the forearm and foot skin and soft tissue defects as free flap, which is a feasible way to repair soft tissue defects in extremities.

Citation： TANG Juyu, HE Jiqiang, WU Panfeng, ZHOU Zhengbing, YU Fang, QING Liming, PAN Ding, PANG Xiaoyang, ZENG Lei, XIAO Yongbing, LIU Rui. Repair of skin and soft tissue defects in extremities with the superior lateral genicular artery perforator flap. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(4): 467-470. doi: 10.7507/1002-1892.201811103 Copy

1.	潘寶華, 魯開化, 郭樹忠, 等. 膝上內側筋膜皮瓣修復膝關節周圍軟組織缺損. 中國修復重建外科雜志, 2002, 16(4): 291.
2.	孫廣峰, 聶開瑜, 鄧呈亮, 等. 游離旋髂淺動脈穿支皮瓣修復足踝部皮膚軟組織缺損. 中國修復重建外科雜志, 2016, 30(11): 1396-1399.
3.	陳長順, 胡祥, 鄭前進, 等. 脛后動脈穿支遠端蒂復合組織瓣修復小腿遠端創面. 中國修復重建外科雜志, 2019, 33(1): 75-79.
4.	李倩, 肖海濤, 岑瑛. 選擇性修薄股前外側皮瓣修復足跟及足跟后區缺損. 中國修復重建外科雜志, 2018, 32(3): 350-353.
5.	Hayashi A, Maruyama Y. The lateral genicular artery flap. Ann Plast Surg, 1990, 24(4): 310-317.
6.	Wiedner M, Koch H, Scharnagl E. The superior lateral genicular artery flap for soft-tissue reconstruction around the knee: clinical experience and review of the literature. Ann Plast Surg, 2011, 66(4): 388-392.
7.	Taniguchi Y, Kitano T, Shimoe T, et al. Superior lateral genicular artery flap for coverage of a soft tissue defect after total knee arthroplasty. J Reconstr Microsurg, 2009, 25(8): 479-482.
8.	Spokevicius S, Jankauskas A. Anatomy and clinical applications of a composite cutaneo-subcutaneous flap based on the lateral superior genicular vessels. J Reconstr Microsurg, 1995, 11(1): 15-20.
9.	夏曉丹. 股外側穿支皮瓣的應用解剖與臨床研究. 衡陽: 南華大學, 2010.
10.	王樹鋒, 周忠水, 于勝軍, 等. 膝上外側動脈為蒂股骨遠端骨皮瓣的應用解剖. 中華顯微外科雜志, 2001, 24(1): 46-48.
11.	許亞軍, 陳政, 包岳豐, 等. 股前外-膝上外側逆行島狀皮瓣修復小腿軟組織缺損. 中華顯微外科雜志, 2013, 36(1): 63-65.
12.	Morsy M, Sur YJ, Saint-Cyr M, et al. Detailed anatomy of the superior lateral genicular artery for design of a vascularized bone flap from the lateral femoral condyle. Plast Reconstr Surg, 2015, 136(4 Suppl): 14-15.
13.	于曉光, 石碩, 李軍, 等. 膝外上旋股外側動脈降支穿支皮瓣修復膝周圍軟組織缺損. 中華顯微外科雜志, 2014, 37(3): 291-293.
14.	王玉發, 何英敏, 王大偉, 等. 旋股外側動脈降支與膝外上動脈雙軸點皮瓣的臨床應用. 中華顯微外科雜志, 2008, 31(6): 444-446.
15.	高建明, 徐達傳, 儲旭東, 等. 膝上外側動脈穿支髂脛束皮瓣的解剖特點與臨床應用. 中華顯微外科雜志, 2010, 33(6): 450-453.
16.	邢進峰, 陳中, 曹揚, 等. 膝上外側血管復合組織瓣移植的應用解剖. 中國臨床解剖學雜志, 2001, 19(4): 329-331.
17.	邢進峰, 張春, 陳中, 等. 膝上外側動脈復合皮瓣的臨床應用. 中華顯微外科雜志, 2001, 24(3): 211-212.

1. 潘寶華, 魯開化, 郭樹忠, 等. 膝上內側筋膜皮瓣修復膝關節周圍軟組織缺損. 中國修復重建外科雜志, 2002, 16(4): 291.
2. 孫廣峰, 聶開瑜, 鄧呈亮, 等. 游離旋髂淺動脈穿支皮瓣修復足踝部皮膚軟組織缺損. 中國修復重建外科雜志, 2016, 30(11): 1396-1399.
3. 陳長順, 胡祥, 鄭前進, 等. 脛后動脈穿支遠端蒂復合組織瓣修復小腿遠端創面. 中國修復重建外科雜志, 2019, 33(1): 75-79.
4. 李倩, 肖海濤, 岑瑛. 選擇性修薄股前外側皮瓣修復足跟及足跟后區缺損. 中國修復重建外科雜志, 2018, 32(3): 350-353.
5. Hayashi A, Maruyama Y. The lateral genicular artery flap. Ann Plast Surg, 1990, 24(4): 310-317.
6. Wiedner M, Koch H, Scharnagl E. The superior lateral genicular artery flap for soft-tissue reconstruction around the knee: clinical experience and review of the literature. Ann Plast Surg, 2011, 66(4): 388-392.
7. Taniguchi Y, Kitano T, Shimoe T, et al. Superior lateral genicular artery flap for coverage of a soft tissue defect after total knee arthroplasty. J Reconstr Microsurg, 2009, 25(8): 479-482.
8. Spokevicius S, Jankauskas A. Anatomy and clinical applications of a composite cutaneo-subcutaneous flap based on the lateral superior genicular vessels. J Reconstr Microsurg, 1995, 11(1): 15-20.
9. 夏曉丹. 股外側穿支皮瓣的應用解剖與臨床研究. 衡陽: 南華大學, 2010.
10. 王樹鋒, 周忠水, 于勝軍, 等. 膝上外側動脈為蒂股骨遠端骨皮瓣的應用解剖. 中華顯微外科雜志, 2001, 24(1): 46-48.
11. 許亞軍, 陳政, 包岳豐, 等. 股前外-膝上外側逆行島狀皮瓣修復小腿軟組織缺損. 中華顯微外科雜志, 2013, 36(1): 63-65.
12. Morsy M, Sur YJ, Saint-Cyr M, et al. Detailed anatomy of the superior lateral genicular artery for design of a vascularized bone flap from the lateral femoral condyle. Plast Reconstr Surg, 2015, 136(4 Suppl): 14-15.
13. 于曉光, 石碩, 李軍, 等. 膝外上旋股外側動脈降支穿支皮瓣修復膝周圍軟組織缺損. 中華顯微外科雜志, 2014, 37(3): 291-293.
14. 王玉發, 何英敏, 王大偉, 等. 旋股外側動脈降支與膝外上動脈雙軸點皮瓣的臨床應用. 中華顯微外科雜志, 2008, 31(6): 444-446.
15. 高建明, 徐達傳, 儲旭東, 等. 膝上外側動脈穿支髂脛束皮瓣的解剖特點與臨床應用. 中華顯微外科雜志, 2010, 33(6): 450-453.
16. 邢進峰, 陳中, 曹揚, 等. 膝上外側血管復合組織瓣移植的應用解剖. 中國臨床解剖學雜志, 2001, 19(4): 329-331.
17. 邢進峰, 張春, 陳中, 等. 膝上外側動脈復合皮瓣的臨床應用. 中華顯微外科雜志, 2001, 24(3): 211-212.

Chinese Journal of Reparative and Reconstructive Surgery

Repair of skin and soft tissue defects in extremities with the superior lateral genicular artery perforator flap

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