Using Perforators as Recipient Vessels (Supermicrosurgery) for Free Flap Reconstruction of the Knee Region

The purpose of this article is to evaluate the feasibility of a perforator as a recipient vessel to reconstruct soft tissue defects of the knee region. From December of 2006 to August of 2008, total of 25 patients underwent reconstructive procedure using either an anterolateral thigh or an upper medial thigh perforator flap. The flaps were anastomosed in a perforator to perforator manner using supermicrosurgery technique. Minimum of 3 perforators were traced around the knee defect. All flaps survived attached to a recipient perforator with artery diameter ranging from 0.4 to 0.9 mm and accompanying veins ranging from 0.4 to 1.2 mm. This approach allowed reduction in time for pedicle and recipient vessel dissection and minimized the trauma involved during isolation of the vessels. Using the perforator as recipient vessel allows an increase in selection for choice of recipient. By using a perforator as recipient, less time is consumed to secure the vessel, does not need long pedicles for flap, is not bound by the condition of major arteries, and minimizes any risk for major vessel injury while having acceptable flap survival.