Papaioannou Konstantinos, Lallos Stergios, Mavrogenis Andreas, Vasiliadis Elias, Savvidou Olga, Efstathopoulos Nikolaos
Orthopaedic Department, "Thriasio" General Hospital, G, Gennimata Av, 19600, Magoula, Athens, Greece.
J Orthop Surg Res. 2010 Nov 4;5:82. doi: 10.1186/1749-799X-5-82.
Soft tissue necrosis following total knee arthroplasty (TKA) may be the cause of the devastating complication of deep infection. It necessitates an immediate operative intervention because it could potentially jeopardise the arthroplasty or even the limb.
Sixteen consecutive patients with a mean age of 73,8 years (range 47 to76 years) over a 6-year period (January 2003 to December 2008) with wound dehiscence after TKA were enrolled in the present study. Unilateral or bilateral fasciocutaneous V-Y flaps that are differently oriented, depending on the local conditions of the tissues were used to reconstruct the soft tissues defects.
In 15 of the 16 cases studied, the wound was successfully covered with the presented technique while in 1 patient a partial flap loss occurred, which was healed after surgical debridement and the application of vacuum system. No other complications occurred. Knee prosthesis was salvaged in all the patients with a good functional and esthetical outcome.
The presented reconstructive technique is a simple, quick, versatile and reliable solution for the coverage of soft tissue defects following TKA, more than 2 cm width and grade 1 and 2 according to Laing classification, provided the V-Y flaps are applied early in the postoperative period and no complex defects are involved.
全膝关节置换术（TKA）后软组织坏死可能是导致深部感染这一毁灭性并发症的原因。由于它可能会危及关节置换术甚至肢体，因此需要立即进行手术干预。
本研究纳入了2003年1月至2008年12月这6年间连续的16例TKA术后伤口裂开的患者，平均年龄73.8岁（范围47至76岁）。根据组织的局部情况，使用不同方向的单侧或双侧筋膜皮V-Y皮瓣来修复软组织缺损。
在16例研究病例中，15例患者的伤口通过所介绍的技术成功覆盖，1例患者出现部分皮瓣坏死，经手术清创和应用负压系统后愈合。未发生其他并发症。所有患者的膝关节假体均得以保留，功能和美观效果良好。
所介绍的重建技术是一种简单、快速、通用且可靠的解决方法，用于覆盖TKA后宽度超过2 cm且根据Laing分类为1级和2级的软组织缺损，前提是在术后早期应用V-Y皮瓣且不涉及复杂缺损。
