Avoiding knee skin sloughs.

To avoid skin sloughs about the knee following knee arthroplasty, the principles that need to be emphasized are the blood supply in the area so that appropriate incisions can be designed; careful operative technique to avoid hematomas; appropriate use of drains and dressings; and postoperative care that monitors increased range-of-motion as it affects the wound. Should secondary coverage be needed, the options include secondary closure, skin graft, muscle or myocutaneous flaps, and on rare occasions, a free tissue transfer. In this way, the plastic surgeon can assist the orthopaedist by providing the appropriate soft tissue coverage in difficult knee surgical situations.