Proximally-based Vastus Lateralis Flap for Anterior or Lateral Hip Coverage

Description

In this instructional video, Dr. Janet Conway presents a detailed overview of the vastus lateralis flap, discussing its application in surgical procedures, particularly for covering anterior hip wounds that follow infections. The discussion begins with the anatomy surrounding the distal femoral condyle and the importance of making a precise incision along the lateral border of the femur.



Dr. Conway describes the steps involved in isolating the vastus lateralis muscle from the quadriceps tendon and the challenges that can arise in distinguishing it from the vastus intermedius. Emphasizing the need for careful ligation of perforators to ensure proper blood flow, she outlines techniques for effectively elevating the muscle and advancing it into the wound bed.



Throughout the procedure, she highlights the significance of maintaining vascularity to optimize healing and discusses the potential for using this flap not only for anterior hip coverage but also for anterior knee wounds. Dr. Conway shares her personal experiences and successes in using this flap in surgical settings, stressing the balance between an extensive dissection and the need for effective tissue coverage.



The video also touches on technical considerations such as using a Bovie for bleeding control, strategies for tunneling the flap under the fascia, and maximizing the muscle's excursion for optimal placement. Dr. Conway concludes by addressing the ease of rotating the vastus lateralis flap for various applications, underlining its versatility and effectiveness in reconstructive surgery.

DOI: 10.1302/3114-230040

Specialties