Circular skin incision down to the crural fascia a good handbreadth inferior to the knee joint/tibial plateau. Fashion a full-thickness skin sleeve by sharp and blunt dissection until the outline of the knee joint space up to the patellar ligament appears. First, fashion the anterior skin sleeve until the patellar ligament is exposed. Dissection will reveal the post-inflammatory soft tissue oedema characteristic of PAD stage IV. Divide the great saphenous vein between clamps.
Tip:
The skin around the knee is highly elastic and retracts more than usual. Skin closure under tension will definitely result in impaired wound healing with skin necrosis.
