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