ABSTRACT
Soft-tissue coverage of lower extremity defects with thin, sensate, mobile, and durable
soft tissue is challenging. Reconstructive options are further limited in the setting
of a below-knee amputation. The authors present the first report of an innervated
thoracodorsal artery perforator (TAP) flap for coverage of an anterior knee soft-tissue
defect in a patient with bilateral below-knee amputations following disseminated meningococcemia.
The soft-tissue defect measured 11 × 17 cm2 centered over the patella, and the TAP flap provided adequate pedicle length, with
optimal soft-tissue thickness and pliability with the potential for innervation and
minimal donor-site morbidity. Six months postoperatively, the patient is ambulating
well with prostheses fitted over her well-healed, stable, knee coverage.
KEYWORDS
Below-knee amputation - TAP flap - fasciocutaneous free flap
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Roman J SkorackiM.D.
University of Texas M.D. Anderson Cancer Center, Department of Plastic Surgery
Unit 443, P.O. Box 301402, Houston, TX 77230
