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Which comorbidity is most significantly associated with the early surgical wound complications requiring surgical interventions following primary total knee arthroplasty?
Type 2 diabetes mellitus
Previous arthroscopic knee surgery
Post-operative aspirin DVT prophylaxis
Body mass index of 31 kg/m^2
Tourniquet use for 70 minutes
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A 62-year-old female underwent a primary total knee arthroplasty of the left knee 10 days ago. She presents to clinic with skin necrosis of the midline incision. There is no deep infection present upon aspiration of the knee joint. She undergoes superficial irrigation and debridement and is left with exposed patellar tendon as shown in Figure A. What is the most appropriate next step in management?
Split thickness skin grafting
Twice daily wet-to-dry dressing changes with Dakin's solution until healing by secondary intention
Latissimus dorsi free flap transfer
Vacuum-assisted closure device until healing by secondary intention
Medial gastrocnemius muscle flap transfer and skin grafting