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.

Free perforator flaps vs propeller flaps in lower limb reconstruction: A cost/effectiveness analysis on a series of 179 cases

Injury ◽  
2019 ◽  
Vol 50 ◽  
pp. S11-S16 ◽  
Author(s):  
Marco Innocenti ◽  
Irene Dell'Acqua ◽  
Matteo Famiglietti ◽  
Livia Vignini ◽  
Giulio Menichini ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Lower Limb ◽  
Cost Effectiveness Analysis ◽  
Perforator Flaps ◽  
Limb Reconstruction ◽  
Effectiveness Analysis ◽  
Lower Limb Reconstruction

Our Experience in Lower Limb Reconstruction With Perforator Flaps

2007 ◽  
Vol 58 (5) ◽  
pp. 507-512 ◽  
Author(s):  
Jaume Masia ◽  
Fabrizio Moscatiello ◽  
Gemma Pons ◽  
Manuel Fernandez ◽  
Susana Lopez ◽  
...  
Keyword(s):  
Lower Limb ◽  
Perforator Flaps ◽  
Limb Reconstruction ◽  
Lower Limb Reconstruction

Muscle versus Fasciocutaneous Flap in Lower Limb Reconstruction: Is There a Best Option?

2017 ◽  
Vol 33 (S 01) ◽  
pp. S27-S33 ◽  
Author(s):  
Martina Corno ◽  
Salvatore D'Arpa ◽  
Pietro Di Summa ◽  
Igor Pellegatta ◽  
Luigi Valdatta ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Donor Site ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Muscle Flaps ◽  
Limb Reconstruction ◽  
Lower Limb Reconstruction ◽  
Tissue Defects

AbstractSoft tissue defects of the lower extremity that expose underlying bones, joints, and tendons pose challenging problems and generally require free tissue transfer for a successful reconstruction. Historically, muscle flaps were the gold standard choice for lower limb reconstruction. To obviate the unpredictable appearance and high donor-site morbidity of muscle flaps, fasciocutaneous flaps were introduced. Recently, perforator flaps, such as the anterolateral thigh flap, gained a leading role in the reconstructive scenario. There is growing evidence in the literature supporting that fasciocutaneous and perforator flaps are comparable to muscle flaps in terms of flap survival, postoperative infection, osteomyelitis, bone union, and ambulation. With the advances of knowledge in perforator anatomy and their mapping, a new era of lower limb reconstruction has begun. Propeller flap could be raised on any suitable perforator vessel and, without the aid of microsurgical anastomosis, used to restore small- to middle-sized soft tissue defects. In this review, we intend to analyze pros and cons of muscle and fasciocutaneous free flaps and the applicability of the propeller flaps in lower limb reconstruction.

Free Flaps in Complex Lower Limb Reconstruction - 2-Year Experience

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Horácio Zenha ◽  
Carla Diogo ◽  
Sara Ramos ◽  
Susana Pinheiro ◽  
Ricardo Carvalho ◽  
...  
Keyword(s):  
Lower Limb ◽  
Free Flaps ◽  
Limb Reconstruction ◽  
Lower Limb Reconstruction

Canadian Trends in Free Flap Management for Microsurgical Lower Limb Reconstruction

2021 ◽  
pp. 229255032110196
Author(s):  
Michelle Bonapace-Potvin ◽  
Alexander Govshievich ◽  
Laurent Tessier ◽  
Mihiran Karunanayake ◽  
Dominique Tremblay ◽  
...  
Keyword(s):  
Lower Limb ◽  
Free Flaps ◽  
Online Questionnaire ◽  
Limb Reconstruction ◽  
Changing Practice ◽  
Current State ◽  
Lower Limb Reconstruction ◽  
Tumor Extirpation ◽  
Based Medicine ◽  
Previous Training

Introduction: Free tissue transfers have become a mainstay in lower limb salvage, allowing safe and reliable reconstruction after trauma, tumor extirpation, and complex wounds. The optimal perioperative (PO) management of these flaps remains controversial. This study aims to assess the current state of practice among Canadian microsurgeons. Methods: Sixty-four Canadian microsurgeons were approached to complete an online questionnaire regarding their PO management of fasciocutaneous free flaps used for lower limb reconstruction. Trends in dangling timing and duration, use of venous couplers, compressive garments, thromboprophylaxis, and surgeons’ satisfaction with their protocol were assessed. Results: Twenty-eight surgeons responded. Fifty-seven percent did not have a specific mobilization protocol. Dangling was mainly initiated on postoperative days 5 to 6 (44%). The most common protocol duration was 5 to 6 days (43%). The concern for prolonged venous pooling was the main reason for delay of dangling (71%). Compressive garments were placed routinely by 12 surgeons (43%) with 20% starting before dangling, 46% with dangling, and 33% after dangling. Venous couplers were routinely used by 24 surgeons (85.7%). Trends in management were influenced by previous training in 53.6% of cases (vs evidence-based medicine 7.1%). Although 89.3% were satisfied with their approach, 92.8% would consider changing practice if higher-level evidence was available. Conclusions: The majority of Canadian microsurgeons initiate dangling early and utilize venous couplers. However, the use of compressive garments is limited. Trends in management are largely based on personal experience. Nearly all surgeons would consider changing their practice if higher-level evidence was available.

Lower limb reconstruction with bone free flaps: experience of 25 cases

2011 ◽  
Vol 35 (5) ◽  
pp. 359-364
Author(s):  
Luís Azevedo ◽  
Horácio Zenha ◽  
Leonor Rios ◽  
Hugo Sequeira ◽  
Gustavo Coelho ◽  
...  
Keyword(s):  
Lower Limb ◽  
Free Flaps ◽  
Limb Reconstruction ◽  
Lower Limb Reconstruction
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