Riassunto
Le complicanze della ferita chirurgica in seguito a intervento di artroprotesi totale di ginocchio sono infrequenti ma possono causare necrosi della cute e dei tessuti molli periprotesici con possibile esposizione dell’osso e/o dell’impianto, con alto rischio di infezione della protesi. In presenza di complicanze a carico della ferita chirurgica, è necessario intervenire immediatamente e in maniera idonea. Ancora oggi non esiste un orientamento terapeutico universalmente accettato per il trattamento delle perdite di sostanza periprotesiche di ginocchio. I lembi muscolari rappresentano il trattamento standard, soprattutto in caso di esposizione e infezione dell’impianto. I lembi perforanti sono stati recentemente introdotti nella pratica clinica e sono caratterizzati da alcuni peculiari vantaggi come la bassa morbilità del sito donatore e i loro lunghi peduncoli.
Abstract
Wound complications following total knee arthroplasty are infrequent but they can lead to skin necrosis and complex soft tissue defects with possible exposure of bone and/or hardware and high risk of periprosthetic infection. When wound complications occur, prompt management is mandatory. There is much controversy regarding the optimal management of wound necrosis around a total knee. Local wound care, debridement, fasciocutaneous, muscle and perforator flaps have been differently used. Muscle coverage remains the standard to which all other flaps should be compared, especially in infected wounds. Perforator flaps have recently represented a true revolution in the soft tissue reconstruction around the knee, with peculiar advantages due to their low donor morbidity and long pedicles.
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Vasso, M., Cerciello, S., Salgarello, M. et al. Trattamento moderno delle perdite di sostanza periprotesiche di ginocchio. Aggiornamenti 18, 1–6 (2012). https://doi.org/10.1007/s10351-012-0001-5
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DOI: https://doi.org/10.1007/s10351-012-0001-5