Abstract
Purpose
Gastrocnemius flaps provide reliable reconstructive solutions to soft-tissue loss of the knee and proximal tibia following orthopedic procedures. While this technique has been used and studied, little is known about its prophylactic application. Single-stage and delayed approaches were compared with respect to the timing of débridement, complications, and relationship between microorganisms and complications.
Methods
Gastrocnemius flaps for soft-tissue defects of the knee joint were retrospectively reviewed. Success of the flap procedure was defined as a healed soft-tissue envelope, no evidence of infection, a good blood supply to the flap, and adherence of the flap to its bed. Independent sample
t
test was used to compare the corresponding parameters (level of statistical significance was 0.05).
Results
Of 43 flaps (43 patients), 18 were performed during a single-stage procedure along with the orthopedic procedure and 25 were delayed. Success of the single-stage (100%) and delayed flaps (88%) was not significantly different (
p
= 0.083). Complication rate did not differ significantly for single-stage (11%) and delayed flaps (24%) (
p
= 0.272). We were unable to establish a relationship between complications and microorganisms.
Conclusion
Results indicate both approaches are reliable. Single-stage gastrocnemius flaps may eliminate the need for a second surgery.
Level of Evidence
Level III (Therapeutic, Retrospective cohort)