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KMID : 0853020140170010030
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Journal of Korean Burn Society
2014 Volume.17 No. 1 p.30 ~ p.33
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Staged Operation Using Fasciocutaneous Transposition Flap on Reconstruction of Exposed Patella Region in 4th Degree Burn: Case Report
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Lee Jae-Un
Lim Soo-A
Song Jin-Kyung
Yoon Yong-Il
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Abstract
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Purpose: Soft tissue injuries of the patellar region are difficult problems because of insufficient arterial blood supply and lack of muscle. There have been many methods for recon-structing the soft tissue injuries of the patellar area such as primary closure, skin graft, muscle flap and free tissue tra-nsfer. However, each method has some limitations in their application. We used fasciocutaneous transposition flap ac-cording to limitations of patient`s condition.
Methods: A 67-year-old-man was hospitalized by contact burn with TBSA 15% involving scalp, back, buttock, both legs. We found 20×30 cm2 sized eschar on right knee. We debrided necrotizing patella bone and found insufficient blood supply. In addition, general weakness, low weight (170 cm/42 kg), old age, DM made us to plan 2 staged operation. At first, coverage using medial fascio-cutaneous transpo-sition flap. After 7 days, there were 1/4 necrosis by conges-tion. we used Vancomycin for systemic antibiotic treatments and betadine irrigation. 2 weeks after, We debrided necrotiz-ing patella bone and coverage using lateral fascio-cutaneous transposition flap.
Results: There were no post-operative complications such as infection, hematoma, seroma or flap necrosis. And there was no contracture or contour deformity.
Conclusion: Due to limitations of patient’s condition, we used fasciocutaneous transposition flap instead of musculocuta-neous flap or free flap. We gained satisfactory result by using fasciocutaneous flap in patella exposed wound reconstruc-tion
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KEYWORD
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Fasciocutaneous flap, Knee reconstruction
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