{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T07:10:13Z","timestamp":1769584213461,"version":"3.49.0"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Soft tissue reconstruction around the knee area is still an open question, particularly in persistent infections and multiple reoperations scenario. Flap coverage should guarantee joint mobility and protection, even when foreign materials are implanted. The chimeric harvesting of the musculocutaneous gastrocnemius flap, based on the sural artery perforators, can extend its applicability in soft tissue reconstruction of the upper leg, overcoming the drawbacks of the alternative pedicled flaps.<\/jats:p><jats:p>\n          Methods\u2003A multicenter retrospective study was conducted enrolling patients who underwent to a pedicled, chimeric gastrocnemius musculocutaneous\u2013medial sural artery perforator (GM-MSAP) or lateral sural artery perforator (GM-LSAP) flap for knee coverage in total knee arthroplasty (TKA) recurrent infections and oncological or traumatic defects of the upper leg from 2018 to 2021. Outcomes evaluated were the successful soft tissue reconstruction and flap complications. Surgical timing, reconstruction planning, technique, and rehabilitation protocols were discussed.<\/jats:p><jats:p>\n          Results\u2003Twenty-one patients were included in the study. Nineteen GM-MSAPs and 2 GM-LSAPs were performed (soft tissue reconstruction in infected TKA [12], in infected hardware [4], and in oncological patients [5]). Donor site was closed primarily in 9 cases, whereas a skin graft was required in 12. Flap wound dehiscence (1), distal flap necrosis (1), distal necrosis of the skin paddle (1), and donor site infection (1) were the encountered complications. Flap reraise associated to implant exchange or extensive debridement was successful without requiring any further flap surgery.<\/jats:p><jats:p>\n          Conclusion\u2003The propeller\u2013perforator GM-MSAP offers qualitative defect coverage and easiness of multiple flap reraise due to skin availability and its laxity.<\/jats:p>","DOI":"10.1055\/s-0043-1768644","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T23:09:30Z","timestamp":1692918570000},"page":"593-600","source":"Crossref","is-referenced-by-count":6,"title":["Role of the Gastrocnemius Musculocutaneous with a Propeller Style Skin Flap in Knee Region Reconstruction: Indications and Pitfalls"],"prefix":"10.1055","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2716-8607","authenticated-orcid":false,"given":"Gianluca","family":"Sapino","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3333-0757","authenticated-orcid":false,"given":"Rik","family":"Osinga","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-2732","authenticated-orcid":false,"given":"Michele","family":"Maruccia","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University Hospital of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2019-002X","authenticated-orcid":false,"given":"Martino","family":"Guiotto","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1598-2209","authenticated-orcid":false,"given":"Martin","family":"Clauss","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Trauma Surgery, University Hospital of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7851-2300","authenticated-orcid":false,"given":"Olivier","family":"Borens","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9815-2173","authenticated-orcid":false,"given":"David","family":"Guillier","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery, University Hospital, Dijon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro Giovanni","family":"di Summa","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.2106\/JBJS.G.01371","article-title":"Surgical treatment of early wound complications following primary total knee arthroplasty","volume":"91","author":"D D Galat","year":"2009","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.bjps.2018.11.002","article-title":"ALT flap with vascularized fascia lata for one-stage functional patellar tendon reconstruction","volume":"72","author":"G Sapino","year":"2019","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"314","DOI":"10.29252\/wjps.7.3.314","article-title":"Gastrocnemius myocutaneous flap: a versatile option to cover the defect of upper and middle third leg","volume":"7","author":"J Rao","year":"2018","journal-title":"World J Plast Surg"},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"3679","DOI":"10.1016\/j.injury.2021.04.009","article-title":"Gastrocnemius pedicled muscle flap for knee and upper tibia soft tissue reconstruction. 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