Repair of knee deep burn wound with descending genicular artery-saphenous artery perforator flaps in elderly patients (a STROBE-compliant article)

It is difficult to repair knee deep burn wounds in elderly patients. In this study, we observed the therapeutic effects of descending genicular artery-saphenous artery perforator flaps on knee deep burn wounds in elderly patients. Between December 2013 and February 2018, we repaired knee third-degree burn wounds using descending genicular artery-saphenous artery perforator flaps of 20 × 12 cm to 23 × 13 cm in 56 elderly patients. For the patella and patellar ligament with complete necrosis, the patella and patellar ligament were completely removed, whereas for the patella and patellar ligament with partial necrosis, necrotic parts were removed first. The donor area was repaired using intermediate thickness free skin graft. The 56 patients were 76- to 85 years’ old and all had unilateral knee burn. All flaps survived in the 56 patients. After the follow-up of 2 to 36 months, the flaps were excellent in texture and appearance, and exhibited sensory recovery. In the 8 patients with completely necrotic patella and patellar ligament as well as open knee joint, the weight-bearing function of knee joint was retained, which met patients’ requirements of limb salvage and weight-bearing function. In the other 48 patients with partially necrotic patella and patellar ligament as well as open joint capsule, the postoperative flexion and extension of the knee joint were good. In elderly patients, it is an effective method to repair knee deep burn wounds using the descending genicular artery-saphenous artery perforator flaps.