Purpose
The aim of this paper was to evaluate the outcomes of propeller perforator flaps used
all over the body, and to appreciate their advantages and/or disadvantages over the
free perforator flaps.
Method
Patients that required propeller perforator flaps used all over the body were eligible
to participate in this study. A preoperative Doppler examination was performed for
all the flaps in the trunk and thigh, but not regularly in the face, lower leg, foot,
forearm and hand. We evaluated the most important technical aspects of harvesting
the flaps, the main indications and advantages of using propeller perforator flaps,
their disadvantages and complications.
For post-excisional face and trunk defects after cancer or decubitus ulcers were performed
approximately 25% of flaps.
Results
We had very good results in approximately 70% of cases. In the remaining cases, excepting
3 cases in which the flaps were completely lost, we registered only minor complications
due to venous congestion, which were solved spontaneously or by skin grafting.
Conclusion
The main advantages of propeller perforator flaps, i.e. no need of microvascular anastomoses,
replacing like-with-like, faster functional rehabilitation, can reduce in well selected
cases the indication for free flaps. The rate of complications is not higher than
by using other methods. The single real disadvantage of propeller perforator flaps
is the location of the perforator close to the defect, what can be an impediment in
trauma cases.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Perforator-based flaps for low posterior midline defects.Plast Reconstr Surg. 1988; 81: 561-566
- Inferior epigastric artery skin flaps without rectus abdominis muscle.Br J Plast Surg. 1989; 42: 645-648
- Microsurgical nonmicrovascular flaps in forearm and hand reconstruction.Microsurgery. 2007; 27: 384-394
- Propeller perforator flaps in distal lower leg: evolution and clinical applications.Arch Plast Surg. 2012; 39: 94-105
- Pedicled perforator flaps for the lower limb.Semin Plast Surg. 2006; 20: 103-111
- Perforators of the lower leg: analysis of perforator locations and clinical application for pedicled perforator flaps.Plast Reconstr Surg. 2008; 122: 161-170
- Freestyle pedicle perforator flaps: clinical results and vascular anatomy.Plast Reconstr Surg. 2010; 126: 1589-1603
- Skin perforator flaps: an algorithm for leg reconstruction.J Reconstr Microsurg. 2011; 27: 511-523
- Pedicled perforator flaps: a new principle in reconstructive surgery.Plast Reconstr Surg. 2010; 125: 201-208
- Perforator flap entity.Clin Plast Surg. 2003; 30: 325-329
- Medial and lateral malleolar perforator flaps for repair of defects around the ankle.Ann Plast Surg. 2003; 51: 579-583
- Plantar flaps based on perforators of the plantar metatarsal/common digital arteries.J Reconstr Microsurg. 2014; 30: 469-474
- Harvesting of forearm perforator flaps based on intraoperative vascular exploration: clinical experiences and literature.Microsurgery. 2008; 28: 321-330
- The radial artery pedicle perforator flap: vascular analysis and clinical implications.Plast Reconstr Surg. 2010; 125: 1469-1478
- The cutaneous arteries of the human body.Springer-Verlag, New York1983
- Arteries of the skin.in: Taylor G.I. Tempest M. Churchill Livingstone, London1988
- The vascular territories (angiosomes) of the body: experimental study and clinical applications.Br J Plast Surg. 1987; 40: 113-141
- Perforasome theory: vascular anatomy and clinical implications.Plast Reconstr Surg. 2009; 124: 1529-1544
- Freestyle pedicle perforator flaps: clinical results and vascular anatomy.Plast Reconstr Surg. 2010; 126: 1589-1603
- Pedicled perforator flaps: a new principle in reconstructive surgery.Plast Reconstr Surg. 2010; 125: 201-208
- The reversed forearm fasciocutaneous flap in hand reconstruction: 10 successful cases.Chin J Plast Surg Burns. 1988; 4: 41-49
- The propeller flap method.Br J Plast Surg. 1991; 44: 53-54
- The propeller flap version of the adductor muscle perforator flap for coverage of ischial or trochanteric pressure sores.Ann Plast Surg. 2006; 56: 540-542
- The “Tokyo” consensus on propeller flaps.Plast Reconstr Surg. 2011; 127: 716-722
- The value of fluorescein in predicting the viability of arterialized flaps.Plast Reconstr Surg. 1977; 60: 710-719
- The safety of intravenous fluorescein administration.Ann Plast Surg. 1991; 26: 551-553
- Assessment of microcirculation of an axial skin flap using indocyanine green fluorescence angiography.Plast Reconstr Surg. 1995; 96: 1636-1649
- Intraoperative evaluation of skin-flap viability using laser-induced fluorescence of indocyanine green.Br J Plast Surg. 2002; 55: 635-644
- Real-time intraoperative near-infrared fluorescence angiography for perforator identification and flap design.Plast Reconstr Surg. 2009; 123: 125e-127e
Article info
Publication history
Published online: October 21, 2019
Footnotes
☆This paper is part of a Supplement supported by the European Federation of Societies of Microsurgery (EFSM) and the Serbian Society for Reconstructive Microsurgery (SSRM).
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
