Distally-based Vastus Lateralis Flap for Knee and Thigh Wound Coverage

Description

In this instructional video, Dr. Janet Conway discusses the surgical technique of using the vastus lateralis muscle as a distally based pedicle flap for wound coverage around the knee region. The video begins by emphasizing the importance of maintaining proper dissection limits, specifically keeping a hand breadth or about 10 centimeters from the superior pole of the patella, which serves as the pivot point for the flap. Dr. Conway explains how to identify and dissect the vastus lateralis, highlighting the need to ligate its proximal pedicle while ensuring blood flow is preserved throughout the process.



The procedure involves careful mobilization of the vastus lateralis to provide adequate muscle coverage for wounds, particularly in the anterior aspect of the knee or distal femur. Dr. Conway demonstrates the dissection technique, detailing how to navigate the muscle layers and emphasizing the importance of a large incision to facilitate the operation. The segment addresses practical considerations such as the use of drains post-surgery and managing perforators during the harvest.



As Dr. Conway showcases the dissection, she discusses the challenges of detaching the muscle from the intermedius and provides tips on using surgical tools effectively. Throughout the video, she highlights the versatility of the vastus lateralis flap, especially in addressing open distal femur fractures or complications arising from total knee arthroplasties, underscoring its capacity to provide essential coverage and the nuances of the surgical technique.

DOI: 10.1302/3114-230047

Specialties