Imaging and Surgical Principles of the Propeller and Perforator Flaps of the Lower Limb

2014 ◽  
pp. 609-642
Author(s):  
Emanuele Cigna ◽  
Michele Maruccia ◽  
Alessandro Napoli ◽  
Federico Lo Torto ◽  
Paola Parisi ◽  
...  
Keyword(s):  
Lower Limb ◽  
Perforator Flaps

Retrospective Analysis in Lower Limb Reconstruction: Propeller Perforator Flaps versus Free Flaps

2017 ◽  
Vol 33 (S 01) ◽  
pp. S34-S39 ◽  
Author(s):  
Marta Cajozzo ◽  
Alessandro Innocenti ◽  
Massimiliano Tripoli ◽  
Giovanni Zabbia ◽  
Salvatore D'Arpa ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Retrospective Analysis ◽  
Revision Surgery ◽  
Lower Limb ◽  
Lower Extremities ◽  
Free Flaps ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Hospitalization Period ◽  
Tissue Defects

Background Technical advancements and increasing experience in the management of soft tissue defects in lower extremities have led to the evolution of decisional reconstructive algorithms. Both propeller perforator flaps (PPFs) and free flaps (FFs) proved to be useful methods of reconstruction for lower extremities defects, offering alternative reconstructive tools. We present a case series of PPFs and FFs for reconstruction of lower limbs defects, analyzing and comparing treatment and outcomes. Methods Through a retrospective analysis, we report our experience in performing PPFs or FFs for reconstruction of soft tissue defects of the lower extremities, in patients admitted between 2010 and 2015 at the Department of Plastic and Reconstructive Surgery, University of Palermo. In these patients, we evaluated location and causes of defects, types of flaps used, recipient vessels, complications, time to healing, and aesthetic outcome. Results A primary healing rate was obtained in 13 patients for PPF and 16 cases for FF. Revision surgery for partial skin necrosis was required in eight cases (PPF: four and FF: four). Recovery time and hospitalization period were eventually shorter in patients with FFs, due to lower rate of complications and revision surgery. Conclusion In the past years, our indications for reconstruction with PPFs in the lower limb have become more restricted, while we favor reconstruction with FFs. Recommendations are provided to orient surgical treatment in small, medium, and large lower limb defects.

Lower limb perforator flaps: Current concept

2020 ◽  
Vol 65 (5-6) ◽  
pp. 496-516
Author(s):  
B. Chaput ◽  
T. Meresse ◽  
F. Bekara ◽  
J.L. Grolleau ◽  
D. Gangloff ◽  
...  
Keyword(s):  
Lower Limb ◽  
Current Concept ◽  
Perforator Flaps

scholarly journals Pedicled Perforator Flaps for the Lower Limb

2006 ◽  
Vol 20 (2) ◽  
pp. 103-111 ◽  
Author(s):  
Omar Quaba ◽  
Awf Quaba
Keyword(s):  
Lower Limb ◽  
Perforator Flaps

scholarly journals The suprafascial course of lower leg perforators: An anatomical study

2020 ◽  
Vol 47 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Luca Vaienti ◽  
Giuseppe Cottone ◽  
Francesco De Francesco ◽  
Francesco Borelli ◽  
Giovanna Zaccaria ◽  
...  
Keyword(s):  
Lower Limb ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Lower Leg ◽  
Present Knowledge ◽  
Perforator Flaps ◽  
Surgical Exploration ◽  
Branching Patterns

Background Perforator mapping has been well described in the literature. Once the suprafascial plane is reached, the course of perforators is considered constant. However, the surgeon must be aware of whether an anastomosis exists between perforators superficially to the fascia, in order to choose the best vessel upon which to base the reconstruction. Our retrospective <i>in vivo</i> anatomical study of lower leg perforator flaps presents the first description of variations in the suprafascial path of perforators, which may influence preoperative flap design.Methods An anatomical study of lower limb perforators was performed on 46 nonconsecutive patients who were referred to our department from June 2012 to October 2018. Reconstruction with perforator-based propeller flaps was planned for each of the patients. In total, 72 perforators were preoperatively identified and surgically isolated. The suprafascial course of each perforator was reported.Results During suprafascial surgical exploration, branching patterns were observed in four perforators. These perforators had been classified as single vessels in the preoperative ultrasonographic analysis. However, after surgical dissection, distal converging branches were noted in two of them.Conclusions Our study is the first description in the literature of suprafascial converging perforators, which might constitute an obstacle to planned reconstruction procedures. Despite the accuracy of preoperative evaluations, anatomical variations were present. Knowledge of suprafascial perforator variations may help surgeons to choose the correct perforator upon which to base a planned flap.

scholarly journals Perforator flaps for reconstruction of lower limb defects

2016 ◽  
pp. 2109-2114 ◽  
Author(s):  
Mir Yasir ◽  
Adil Wani ◽  
Haroon Zargar
Keyword(s):  
Lower Limb ◽  
Perforator Flaps ◽  
Limb Defects

Thin Perforator Flaps for Reconstruction of the Lower Extremity

2019 ◽  
Author(s):  
Peggy J. Ebner ◽  
Daniel J. Gould ◽  
Ketan M. Patel
Keyword(s):  
Lower Limb ◽  
Lower Leg ◽  
Soft Tissue Coverage ◽  
Patient Centered ◽  
Perforator Flaps ◽  
Limb Reconstruction ◽  
Flap Survival ◽  
Flap Transfer ◽  
Viable Solution ◽  
Lower Limb Reconstruction

AbstractThin flaps, a modification of traditional flaps that minimize the need for debulking and revision, offer unique advantages in the field of lower limb reconstruction. Advances in the field of microsurgery have made this streamlined method of reconstruction a viable solution for soft tissue coverage in patients with both trauma and nonhealing wounds. Better understanding of anatomy has allowed for flap harvest above the fascia level and the Scarpal plane. These modifications allow for flap transfer with thicknesses more comparable to the native anatomy of the lower leg, ankle, and foot. Flap survival is comparable to traditional techniques with greater potential for improved patient-centered outcomes.

Combining local and perforator flaps in the lower limb

2010 ◽  
Vol 63 (12) ◽  
pp. 2203-2204
Author(s):  
A.C.S. Woollard ◽  
A. Mosahebi
Keyword(s):  
Lower Limb ◽  
Perforator Flaps

Functional Outcomes of Posttraumatic Lower Limb Salvage: A Pilot Study of Anterolateral Thigh Perforator Flaps Versus Muscle Flaps

2009 ◽  
Vol 66 (5) ◽  
pp. 1311-1314 ◽  
Author(s):  
Eduardo D. Rodriguez ◽  
Rachel Bluebond-Langner ◽  
Carol Copeland ◽  
T Nicole Grim ◽  
Navin K. Singh ◽  
...  
Keyword(s):  
Pilot Study ◽  
Limb Salvage ◽  
Lower Limb ◽  
Functional Outcomes ◽  
Perforator Flaps ◽  
Muscle Flaps ◽  
Anterolateral Thigh

scholarly journals THE APPLICATION OF THE DISTAL POSTERIOR TIBIAL ARTERY PERFORATOR FLAPS IN CHRONICS WOUNDS

2021 ◽  
Vol 8 (7) ◽  
Keyword(s):  
Lower Limb ◽  
Chronic Wounds ◽  
Skin Flap ◽  
Perforator Flap ◽  
Free Flaps ◽  
Posterior Tibial Artery ◽  
Perforator Flaps ◽  
Posterior Tibial ◽  
Tibial Artery ◽  
Artery Perforator

INTRODUCTION: The reconstruction of lesions in the distal third of the leg is one of the challenges for surgeons. In this scenario, the use of posterior tibial perforator flaps is being used more and more in surgical practice due to their versatility and aesthetic results. MATERIALS AND METHODS: This research consists of an integrative review carried out from a bibliographic survey in the PUBMED and Virtual Health Library (BVS) search platforms. After reading the full 20 articles in total, an overlap of four articles present in the two searches was observed, thus resulting in a total of 16 articles included in this review. RESULTS: The treatment of chronic lower limb wounds caused by infection, diabetes mellitus and osteomyelitis has always been a formidable task. Perforator-free flaps are generally recommended as the therapy of choice in the treatment of chronic lower limb wounds. DISCUSSION: The advantages of the application of the posterior tibial artery skin flap is ideal for small leg defects to reconstruct the exposed bone and tendon. As it is local tissue, it substitutes as tissue. The distal posterior tibial artery perforator flap is a beneficial technique, in the plastic and reconstructive surgery field, especially for the treatment of chronic lower extremity wounds. Keyword : CHRONIC WOUNDS, DISTAL POSTERIAL TIBIAL ARTERY, PERFORATOR FLAP, PLASTIC SURGERY

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