scholarly journals Propeller Flaps: A Review of Indications, Technique, and Results

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Salvatore D'Arpa ◽  
Francesca Toia ◽  
Roberto Pirrello ◽  
Francesco Moschella ◽  
Adriana Cordova
Keyword(s):  
Preoperative Planning ◽  
Large Range ◽  
Current Knowledge ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Review Of The Literature ◽  
Body Regions ◽  
Potential Problems ◽  
One Stage Reconstruction ◽  
Dissection Technique

In the last years, propeller flaps have become an appealing option for coverage of a large range of defects. Besides having a more reliable vascular pedicle than traditional flap, propeller flaps allow for great freedom in design and for wide mobilization that extend the possibility of reconstructing difficult wounds with local tissues and minimal donor-site morbidity. They also allow one-stage reconstruction of defects that usually require multiple procedures. Harvesting of a propeller flap requires accurate patient selection, preoperative planning, and dissection technique. Complication rate can be kept low, provided that potential problems are prevented, promptly recognized, and adequately treated. This paper reviews current knowledge on propeller flaps. Definition, classification, and indications in the different body regions are discussed based on a review of the literature and on the authors’ experience. Details about surgical technique are provided, together with tips to avoid and manage complications.

scholarly journals Suprafascial Free Flaps: Classification and Comprehensive Review of the Literature

2021 ◽  
Vol 6 ◽  
pp. 247275122110205
Author(s):  
Sebastian Rios ◽  
María Isabel Falguera-Uceda ◽  
Alicia Dean ◽  
Susana Heredero
Keyword(s):  
Survival Rate ◽  
Preoperative Planning ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Anterolateral Thigh Flap ◽  
Cochrane Library ◽  
Review Of The Literature ◽  
Comprehensive Review ◽  
Search Terms

Study Design: Suprafascial free flaps have become common place in reconstructive surgery units. Nomenclature related to these flaps has not been uniform throughout the scientific literature, especially in regard to planes of dissection. This study is designed as a comprehensive review of the literature. Objectives: Our study highlights which flaps are used most frequently, their main indications, their survival rate, and how they have evolved in the last few decades as innovations have been introduced. Methods: A review of the literature was performed using keywords and Medical Subject Headings search terms. PubMed, Embase, and Cochrane Library were searched using the appropriate search terms. Data collected from each study included flap type, dissection plane, preoperative planning, area of reconstruction, as well as complications, donor-site morbidity and survival rate. Results: Seven hundred and fifty-five studies were found based on the search criteria. After full-text screening for inclusion and exclusion criteria 34 studies were included. A total of 1332 patients were comprised in these studies. The most common types of flaps used were superficial circumflex iliac perforator flap (SCIP), anterolateral thigh flap (ALT), and radial forearm flap. The most common areas of reconstruction were head & neck and limbs. There was no significant difference in survival rates between flaps that were raised in different planes of dissection. Conclusions: Based on the author’s review of the literature, suprafascial flaps are reliable, they have low donor site morbidity, and there is a wide selection available for harvest. The use of new technologies for preoperative planning, such as CT-Angiography and UHF ultrasound, have contributed to have more predictable results. We propose a standardized classification for these flaps, in order to create a uniform nomenclature for future reference.

scholarly journals Brachial artery perforator propeller flap reconstruction of post electrical burn defect axilla

2021 ◽  
Vol 8 (10) ◽  
pp. 3211
Author(s):  
Surya Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran ◽  
Suresh Rajendran
Keyword(s):  
Brachial Artery ◽  
Preoperative Planning ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Complication Rates ◽  
Vascular Pedicle ◽  
Propeller Flap ◽  
Current Scenario ◽  
The Right ◽  
Artery Perforator

In the current scenario, propeller flaps are an attractive choice for single stage coverage of a large number of defects. They have a more reliable vascular pedicle than traditional flap and allow for greater freedom in design and wide mobilization and minimal donor-site morbidity. Harvesting of a propeller flap requires appropriate patient selection, preoperative planning, and meticulous dissection and these techniques greatly reduce the complication rates. Here, we present a case of a post burn raw area of the right axilla which was debrided and covered with a brachial artery perforator propeller flap.

scholarly journals Complications and Solutions in Propeller Flap Surgery

2020 ◽  
Vol 34 (03) ◽  
pp. 210-220 ◽  
Author(s):  
Marta Cajozzo ◽  
Lucian P. Jiga ◽  
Zaher Jandali ◽  
Mismil Muradov ◽  
Marco Pignatti ◽  
...  
Keyword(s):  
Preoperative Planning ◽  
Relevant Literature ◽  
Flap Surgery ◽  
High Failure Rate ◽  
Perforator Flaps ◽  
Body Regions ◽  
Management Of Complications ◽  
Wide Range ◽  
Dissection Technique ◽  
Tissue Defects

AbstractPropeller perforator flaps (PPFs) have long been proven as valid reconstructive tools for a wide range of soft tissue defects in different body regions. During the last decade, despite their numerous advantages, many authors have thoroughly analyzed outcomes of these flaps, sometimes discouraging their use mainly because of a high failure rate. Accurate patient selection, adequate preoperative planning, and an appropriate dissection technique seem to potentially improve outcomes. Our study provides a review of the relevant literature related to PPF complications and of our experience, describing reasons for failure, measures for preventing them, and approaches for a prompt evaluation and management of complications.

scholarly journals Propeller Flaps in the Posterior Trunk

2020 ◽  
Vol 34 (03) ◽  
pp. 176-183
Author(s):  
Daniel J Kedar ◽  
Changsik John Pak ◽  
Hyunsuk Peter Suh ◽  
Joon Pio Hong
Keyword(s):  
Surgical Technique ◽  
Preoperative Planning ◽  
Donor Site ◽  
Design Principles ◽  
Review Of The Literature ◽  
Significant Morbidity ◽  
Perforator Flaps ◽  
Primary Donor ◽  
Posterior Trunk ◽  
Elegant Solution

AbstractThe reconstruction of complex posterior trunk defects remains challenging. But now with an increased knowledge of angiosomes and the practice of perforator flaps, the posterior trunk offers a new plethora of options for reconstruction. Propeller flaps based on such perforator(s) offer an elegant solution for managing defects while achieving primary donor-site closure without significant morbidity. We will discuss the relevant anatomy and design principles for propeller flaps based on a review of the literature and our experience. Steps beginning with preoperative planning, perforator selection, and intraoperative surgical technique will be discussed, together with pearls on both avoiding and managing complications.

Donor Site Morbidity Following Free Tissue Transfer: A Preliminary Survey

1998 ◽  
Vol 6 (2) ◽  
pp. 85-88 ◽  
Author(s):  
James Mahoney ◽  
Eric Kharaillah ◽  
Dimitri Drakos
Keyword(s):  
Wound Healing ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Preliminary Survey ◽  
Retrospective Survey ◽  
Tissue Transfer ◽  
Potential Problems ◽  
Radial Forearm

J Mahoney, E Kharaillah, D Drakos. Donor site morbidity following free tissue transfer: A preliminary survey. Can J Plast Surg 1998;6(2):85-88. Donor site morbidity is becoming an important factor in the measurement of reconstructive success following free tissue transfer. A grading system based on five criteria (cosmesis, functional loss, wound healing, iatrogenic injury and pain) has been devised to evaluate and compare different donor sites in a uniform fashion. Questionnaires were sent to microsurgeons across Canada and to a series of patients asking them to report on their experiences with donor site morbidity. Completed questionnaires from 43 patients and 29 surgeons revealed that overall, donor site morbidity is low. This study represents a retrospective survey of the donor site of various free tissue transfers and highlights potential problems of several frequently used free flaps. The radial forearm flap had the highest morbidity, especially with regard to wound healing and cosmesis. Suggestions to improve studies in this area further are made.

scholarly journals The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature

2008 ◽  
Vol 41 (01) ◽  
pp. 24-33
Author(s):  
Mohammed A. Rifaat ◽  
Ayman A. Amin ◽  
Mahmoud A Bassiouny ◽  
Ayman Nabawi ◽  
Sherif Monib
Keyword(s):  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Latissimus Dorsi Flap ◽  
Site Preference ◽  
Review Of The Literature ◽  
Autologous Breast Reconstruction ◽  
Wound Breakdown ◽  
Aesthetic Results

ABSTRACT Background: Autologous breast reconstruction using the extended latissimus dorsi flap has been infrequently reported. in the current study, the authors are reporting their own clinical experience with this method. a review of the literature is also discussed.Materials and methods: Over a three year period, 14 patients underwent breast reconstruction using the extended latissimus dorsi (ld) flap. patients with small to medium sized breasts were selected. the age of the patients ranged from 29 to 42 years with a follow-up period ranging from six to 18 months. the indications, flap-related complications and donor site morbidity and aesthetic results were evaluated.Results: The main indication to use the flap was dorsal donor site preference by patients. the remaining patients were either not suitable for a flap from the abdomen or wished to get pregnant and were offered the dorsal donor site. neither total nor partial flap loss was recorded but donor site morbidity was mainly due to seroma, which was treated conservatively in all patients, except for one who required surgery. another two patients suffered from wound breakdown and distal necrosis of the back flaps. mild contour deformity was also noted on the back of all patients but caused no major concern. indeed, the overall patient satisfaction was very high.Conclusion: The extended ld flap proved to be a good option for autologous breast reconstruction in selected patients. patients should be warned of the potential for seroma and mild contour back deformity.

scholarly journals Investigation Into the Optimal Number of Intercostal Nerve Transfers for Musculocutaneous Nerve Reinnervation: A Systematic Review

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 621-626 ◽  
Author(s):  
Hyuma A. Leland ◽  
Beina Azadgoli ◽  
Daniel J. Gould ◽  
Mitchel Seruya
Keyword(s):  
Systematic Review ◽  
Brachial Plexus ◽  
Donor Site ◽  
Elbow Flexion ◽  
Donor Site Morbidity ◽  
Intercostal Nerve ◽  
Optimal Number ◽  
Musculocutaneous Nerve ◽  
Nerve Transfers ◽  
Meta Analyses

Background: The purpose of this study was to systematically review outcomes following intercostal nerve (ICN) transfer for restoration of elbow flexion, with a focus on identifying the optimal number of nerve transfers. Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify studies describing ICN transfers to the musculocutaneous nerve (MCN) for traumatic brachial plexus injuries in patients 16 years or older. Demographics were recorded, including age, time to operation, and level of brachial plexus injury. Muscle strength was scored based upon the British Medical Research Council scale. Results: Twelve studies met inclusion criteria for a total of 196 patients. Either 2 (n = 113), 3 (n = 69), or 4 (n = 11) ICNs were transferred to the MCN in each patient. The groups were similar with regard to patient demographics. Elbow flexion ≥M3 was achieved in 71.3% (95% confidence interval [CI], 61.1%-79.7%) of patients with 2 ICNs, 67.7% (95% CI, 55.3%-78.0%) of patients with 3 ICNs, and 77.0% (95% CI, 44.9%-93.2%) of patients with 4 ICNs ( P = .79). Elbow flexion ≥M4 was achieved in 51.1% (95% CI, 37.4%-64.6%) of patients with 2 ICNs, 42.1% (95% CI, 29.5%-55.9%) of patients with 3 ICNs, and 48.4% (95% CI, 19.2%-78.8%) of patients with 4 ICNs ( P = .66). Conclusions: Previous reports have described 2.5 times increased morbidity with each additional ICN harvest. Based on the equivalent strength of elbow flexion irrespective of the number of nerves transferred, 2 ICNs are recommended to the MCN to avoid further donor-site morbidity.

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