Soft-tissue Defects After Total Knee Arthroplasty: Management and Reconstruction.
Wound healing complications associated with total knee arthroplasty present a considerable challenge to the orthopaedic surgeon. To ensure preservation of a functional joint, the management of periprosthetic soft-tissue defects around the knee requires rapid assessment, early and aggressive débridement, and durable, contoured coverage. Several reconstructive options are available to tailor soft-tissue coverage to the location, size, and depth of the wound. Special consideration should be given to the timing of the intervention, management of infection, and prosthesis salvage. The merits of each reconstructive option, including perforator, fasciocutaneous, muscular, and free microvascular flaps, should be weighed to select the most appropriate option. The proposed approach can guide surgeons in treating patients with these complex soft-tissue defects.
From the Department of Surgery, Washington University School of Medicine, St. Louis, MO.
Daniel A
DA
Osei
Kelsey A
KA
Rebehn
Martin I
MI
Boyer
D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003646:Debridement; D006801:Humans; D007719:Knee Joint; D019651:Plastic Surgery Procedures / Q000379:methods*; D012307:Risk Factors; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D058106:Wound Closure Techniques; D014945:Wound Healing
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