الفهرس | Only 14 pages are availabe for public view |
Abstract The SLGA flap is an infrequently used alternative in reconstruction of soft-tissue defects around the knee with minimal donor-site morbidity and excellent aesthetic results. (4) Technological improvements in conventional ultrasound, including color duplex imaging, have greatly facilitated the evaluation of vascularrelated problems for virtually every specialty. The noninvasive modalities of Color duplex imaging are more pragmatic method for evaluating the cutaneous circulation. (9) Pedicled perforator flaps offer like-for-like reconstruction, decreased donor site morbidity, a technique that is technically less demanding than free tissue transfers, and a donor site limited to the same area. The superior lateral genicular artery (SLGA) flap is an alternative to muscle flaps. This study reviewed the relevant anatomy and analyzed the results of using this flap for coverage of peri-knee defects (2). The anatomy of the SLGA perforators is consistent and reliable. The perforator was found and located by duplex study about 4.6 cm from the lateral condyle of femur ranged from 3.5 cm the most proximal position and 5.2 the most distal one. The distance was measured on a vertical axis at lateral thigh region from lateral condyle of femur to greater femur trochanter representing flap axis as the septum between vastus lateralis of quadriceps muscle anteriorly and biceps femoris muscle posteriorly. The use of duplex study preoperatively is an excellent predictive tool as it gives detailed accurate location of perforator and with using velocity and diameter of vessel, we can predict complications A defect with medium size (5*7 to 8*12) involving area around knee joint except lateral side can be covered by SLGA flap with primary closure of donor site if width within 6 cm The flap shows best result without complication with vessel diameter 1.2mm or more and velocity of 22mm/sec or more. The duplex study can be an excellent predictive tool for all perforator flaps with good outcome by its valuable data. Post-operative rehabilitation and physiotherapy are very important to achieve best result and range of movement post operative. In Conclusion the following is a flow chart defining when to utilize the different lines of treatment. |