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Knee Region Coverage with Reversed Gracilis Pedicle Flap (GReSP Flap).
C Tiengo1, V Macchi2, A Porzionato2
1Section of Plastic Surgery, Department of Medical and Surgical Sciences, School of Medicine, University of Padova, Via A. Gabelli 65, 35127 Padova, Italy.
JBJS Essential Surgical Techniques
|March 19, 2021
Summary
The extended reversed gracilis flap (GReSP flap) effectively treats severe soft-tissue complications after total knee arthroplasty. This surgical technique reconstructs defects, restoring function and implant coverage in complex cases.
Area of Science:
- Orthopedic Surgery
- Plastic and Reconstructive Surgery
- Biomedical Engineering
Background:
- Severe soft-tissue complications following total knee arthroplasty (TKA) present significant reconstructive challenges.
- Infection and implant exposure are critical issues requiring advanced surgical solutions.
Purpose of the Study:
- To describe and evaluate the efficacy of the extended reversed gracilis flap based on secondary pedicles (GReSP flap) for treating TKA-related soft-tissue complications.
- To present a novel surgical approach for complex reconstructive needs in TKA patients.
Main Methods:
- The GReSP flap technique involves preparing the wound bed, exposing the gracilis muscle while preserving vital structures, and temporarily clamping the main vascular pedicle.
- Mobilization of the muscle flap includes transecting the proximal tendon and ligating pedicles, followed by in-place suturing and skin grafting.
- Postoperative care includes knee immobilization and rehabilitation to restore range of motion.
Main Results:
- The study treated three patients with TKA-associated infections and exposed implants using the GReSP flap.
- The technique successfully covered exposed implants and managed severe soft-tissue defects.
Conclusions:
- The GReSP flap is a viable and effective reconstructive option for managing severe soft-tissue complications after total knee arthroplasty.
- This flap provides a reliable solution for complex cases involving infection and implant exposure, facilitating limb salvage and functional recovery.
