What Is Safe Limit of the Perforator Flap in Lower Extremity Reconstruction? Do We Have Answers Yet?

We make an attempt to define the safe extent of local perforator flap for lower limb reconstruction by comparing it with the limb length of the patient. The maximum flap length from the perforator was compared to the limb length in 35 patients using EPI info 6.04 D software. On comparison of flaps that were less than one-third of limb length to those which were more than one-third of limb length, the statistical values were significant. The odds ratio calculated was 6, which means that there is a six times more chance that a local perforator flap will necrose if it is more than one-third of the limb length as compared to a flap which is less than one-third of the limb length.

Download Full-text

Islanded Posterior Tibial Artery Perforator Flap for Lower Limb Reconstruction: Review of Lower Leg Anatomy

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e318200ad06 ◽

2011 ◽

Vol 127 (2) ◽

pp. 1014-1015 ◽

Cited By ~ 3

Author(s):

Megan C. Jack ◽

Martin I. Newman ◽

Yoav Barnavon

Keyword(s):

Lower Limb ◽

Perforator Flap ◽

Lower Leg ◽

Posterior Tibial Artery ◽

Limb Reconstruction ◽

Posterior Tibial ◽

Tibial Artery ◽

Lower Limb Reconstruction ◽

Artery Perforator

Download Full-text

Use of the Upper Medial Thigh Perforator Flap (Gracilis Perforator Flap) for Lower Extremity Reconstruction

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e3181fed789 ◽

2011 ◽

Vol 127 (2) ◽

pp. 731-737 ◽

Cited By ~ 13

Author(s):

Jin Sup Eom ◽

Sang Hoon Sun ◽

Joon Pio Hong

Keyword(s):

Lower Extremity ◽

Perforator Flap ◽

Medial Thigh ◽

Lower Extremity Reconstruction ◽

Extremity Reconstruction

Download Full-text

The Superficial Circumflex Iliac Artery Perforator Flap in Lower Extremity Reconstruction

Clinics in Plastic Surgery ◽

10.1016/j.cps.2020.12.005 ◽

2021 ◽

Author(s):

Joon Pio Hong

Keyword(s):

Lower Extremity ◽

Iliac Artery ◽

Perforator Flap ◽

Lower Extremity Reconstruction ◽

Extremity Reconstruction ◽

Artery Perforator

Download Full-text

Challenges of Setting up a Lower Extremity Reconstruction Practice in a Constrained Environment

Journal of Reconstructive Microsurgery ◽

10.1055/s-0039-1701041 ◽

2020 ◽

Author(s):

Asli Datli ◽

Ismail Karasoy ◽

Yucel Genc ◽

Ozgur Pilanci

Keyword(s):

Lower Extremity ◽

Administrative Support ◽

Tertiary Care ◽

Perforator Flap ◽

Operation Time ◽

Anterolateral Thigh Flap ◽

Anterolateral Thigh ◽

Lower Extremity Reconstruction ◽

Extremity Reconstruction ◽

Set Up

Abstract Background Microsurgical lower extremity reconstruction remains challenging, especially when resources are limited such as lack of proper equipment, human resources, administrative support, and located in a remote area far from tertiary care. Nevertheless, reconstructive solutions are required, especially when in urgent trauma situations. In this article, we evaluate ways of overcoming challenges and issues that should be considered in a newly established unit by sharing our initial lower extremity reconstruction experience. Methods We report a local hospital's initial lower extremity reconstruction experience in February 2017 to January 2018. Through a total of seven patients, we tried to enhance the environment, instruments, nurses' contribution, and perspective of the peers and community in terms of factors related to the surgeon, hardware, environment, supporting faculty, reimbursement, and patients. Results Four patients underwent reconstruction with a freestyle propeller flap and three with an anterolateral thigh flap; in one case, a superficial circumflex iliac artery perforator flap was chosen to salvage partial flap necrosis. Increased experience of the surgeon, new equipment, continuing nurse/patient education, and collaborating with other departments allowed us to choose more challenging flaps and be more meticulous while decreasing the operation time and hospital stay. Conclusion To start a lower extremity reconstruction practice in a resource-poor environment, the surgeon needs to evaluate the relevant factors; moreover, he or she should continuously improve them until a working methodology is achieved. Despite all the challenges, the adaptations learned at this center can be applied to other local hospitals around the world to set up a lower extremity reconstruction practice and improve its outcomes.

Download Full-text