Thoracodorsal artery perforator (TAP) flap reconstruction of a soft-tissue defect of the knee following below-knee amputation.

Soft-tissue coverage of lower extremity defects with thin, sensate, mobile, and durable soft tissue is challenging. Reconstructive options are further limited in the setting of a below-knee amputation. The authors present the first report of an innervated thoracodorsal artery perforator (TAP) flap for coverage of an anterior knee soft-tissue defect in a patient with bilateral below-knee amputations following disseminated meningococcemia. The soft-tissue defect measured 11 x 17 cm2 centered over the patella, and the TAP flap provided adequate pedicle length, with optimal soft-tissue thickness and pliability with the potential for innervation and minimal donor-site morbidity. Six months postoperatively, the patient is ambulating well with prostheses fitted over her well-healed, stable, knee coverage.