Reconstruction of the Skin Defect of the Knee Using a Reverse Anterolateral Thigh Island Flap

Abstract

A reverse anterolateral thigh island flap with the dimensions of 6 x 3, 15 x 6, and 26 x 8 cm, respectively, was elevated in 3 patients to repair the skin defects in the knee resulting from crush injuries. The pedicle of the flap was isolated in a retrograde fashion along the descending branch of the lateral circumflex femoral artery to obtain sufficient length until the pivot point was reached. The distal point of the defect to which the flap could reach for the reconstruction was 12 cm below the knee. All flaps survived, but skin necrosis occurred in the margins of those 2 large flaps. With a wide arc of rotation and sufficient skin paddle, the reverse anterolateral thigh island flap based on reverse flow is a good option for repairing skin defect around the knee; however, a staged or delayed operation might be considered in elevating a large flap.