Perforator Plus Fasciocutaneous Flaps in the Reconstruction of Post-Burn Flexion Contractures of the Knee Joint
Published: May 1, 2013 | DOI: https://doi.org/10.7860/JCDR/2013/.2968
Madhumita Gupta, Ashwin A. Pai, Ravi R. Setty, Raghavendra Sawarappa, Bijay Kumar Majumdar,
Tibar Banerjee, Aditya Kanoi, Abhimanyu Bhattacharya
1. Resident, Department of Plastic and Reconstructive Surgery,
Ipgme & R, Kolkata, India.
2. Resident, Department of Plastic and Reconstructive Surgery,
Ipgme & R, Kolkata, India.
3. Resident, Department of Plastic and Reconstructive Surgery,
Ipgme & R, Kolkata, India.
4. Resident, Department of Plastic and Reconstructive Surgery,
Ipgme & R, Kolkata, India.
5. Head of the Department, Department of Plastic and
Reconstructive Surgery, Ipgme&R, Kolkata, India.
6. Assistant Professor, Department of Plastic and
Reconstructive Surgery, Ipgme & R, Kolkata, India.
7. Resident, Department of Plastic and Reconstructive
Surgery, Ipgme & R, Kolkata, India.
8. Resident, Department of Anesthesiology, Ipgme & R,
Kolkata, India.
Correspondence
Dr. Madhumita Gupta,
Address: 357/1/1, Prince Anwar Shah Road, Kolkata-700068,
West Bengal, India.
Phone: +91 9836548574
E-mail: docmadhu82@gmail.com
Background: A post-burn flexion contracture of the knee joint is a disabling condition which interferes with an upright posture and a bipedal locomotion. Islanded perforator flaps have been used to resurface the tissue defect which is produced as a result of the contracture release. Despite their various advantages, they are limited by an increased tendency to undergo venous congestion. Perforator-plus flaps can be used to overcome this limitation, while retaining the merits of the islanded perforator flaps.
Methods: Ninteen patients with post flame burn flexion contractures of the knee joints underwent surgical releases and coverages by various local fasciocutaneous perforator-plus flaps. The patients were followed up for 6 months and the various aspects of the functional and the aesthetic rehabilitations were assessed.
Results: All the local fasciocutaneous perforator-plus flaps resurfaced the tissue defect over popliteal fossa with good colour and texture match and maintenance of the contour. None of the flaps had any significant early or delayed complications (which included venous congestions) which necessitated reoperations. All the patients were satisfied with the functional and aesthetic outcomes.
Conclusion: Local fasciocutaneous perforator-plus flaps can be considered as one of the primary treatment modalities for the surgical release and reconstruction of post burn flexion contractures of the knee.
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