Operative management and outcome of complex wounds following total knee arthroplasty.

Abstract:

:This study describes the treatment protocol for and the outcome of the management of complex wounds around total knee replacements. An analysis of 28 patients (29 knees) with complex defects who had surgery between January 1, 1986, and July 30, 1996, was performed. A specific management protocol was applied to each knee on the basis of the size and depth of the wound, the presence of infection, and the quality of soft tissue. Primary treatment included local wound care, debridement, and skin grafting or coverage with a fasciocutaneous flap, pedicled muscle flap, or free muscle transfer. Postoperatively, knees were evaluated using the Knee Society objective score. Successful salvage of the lower extremity was obtained in 28 knees (97 percent) and of the knee prosthesis in 24 of 29 knees (83 percent). Secondary plastic surgery procedures were necessary in five knees (17 percent), and secondary orthopedic procedures were necessary in four knees (14 percent). Successful salvage of total knee arthroplasty in the presence of a complex wound requires early identification of infection, aggressive irrigation and debridement, and early appropriate soft-tissue coverage. The use of our proposed algorithm will facilitate management of these complex wounds.

journal_name

Plast Reconstr Surg

authors

Nahabedian MY,Mont MA,Orlando JC,Delanois RE,Hungerford DS

doi

10.1097/00006534-199911000-00012

subject

Has Abstract

pub_date

1999-11-01 00:00:00

pages

1688-97

issue

6

eissn

0032-1052

issn

1529-4242

journal_volume

104

pub_type

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