The pedicle elongation of submental artery perforator flap for reconstruction in the head and neck

Mapping Intimacies ◽

10.22541/au.162953454.42004951/v1 ◽

2021 ◽

Author(s):

Sisi Lee ◽

Xuexin Tan ◽

kunming Zhao

Keyword(s):

Head And Neck ◽

Buccal Mucosa ◽

Perforator Flap ◽

Perforator Flaps ◽

Submental Artery ◽

Major Complications ◽

Post Operation ◽

Artery Perforator

15 patients successfully received submental artery perforator flaps with its pedicle elongated. The lesions were located in tongue,oropharynx,gingiva,mandible,auricle,infraorbital skin,buccal mucosa and parotid gland.All patients are satisfied with the reconstruction. 15 patients’ donor sites were recovered well and the flaps survival was 100% with no post-operation or further major complications occurred

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Comparison of the Medial Sural Artery Perforator Flap with the Radial Forearm Flap for Head and Neck Reconstructions

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e3181b457cf ◽

2009 ◽

Vol 124 (4) ◽

pp. 1125-1132 ◽

Cited By ~ 57

Author(s):

Huang-Kai Kao ◽

Kai-Ping Chang ◽

Fu-Chan Wei ◽

Ming-Huei Cheng

Keyword(s):

Head And Neck ◽

Perforator Flap ◽

Radial Forearm Flap ◽

Forearm Flap ◽

Radial Forearm ◽

Sural Artery ◽

Artery Perforator

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True submental artery perforator flap for total soft-tissue chin reconstruction

Microsurgery ◽

10.1002/micr.21983 ◽

2012 ◽

Vol 32 (6) ◽

pp. 502-504 ◽

Cited By ~ 7

Author(s):

Shirley Potter ◽

Catherine De Blacam ◽

Damir Kosutic

Keyword(s):

Soft Tissue ◽

Perforator Flap ◽

Submental Artery ◽

Artery Perforator

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The Use of Magnetic Resonance Imaging in Planning a Pedicled Perforator Flap for Pressure Sores in the Gluteal Region

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734618772399 ◽

2018 ◽

Vol 17 (2) ◽

pp. 106-112

Author(s):

Sun-June Park ◽

Kyeong-Tae Lee ◽

Byung-Joon Jeon ◽

Kyong-Je Woo

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Perforator Flap ◽

Gluteal Region ◽

Pressure Sores ◽

Resonance Imaging ◽

Inferior Gluteal Artery ◽

Perforator Flaps ◽

Superior Gluteal Artery ◽

Artery Perforator

Pedicled perforator flaps (PPFs) have been widely used to treat pressure sores in the gluteal region. Selection of a reliable perforator is crucial for successful surgical treatment of pressure sores using PPFs. In this study, we evaluate the role of magnetic resonance imaging (MRI) in planning PPF reconstruction of pressure sores in the gluteal region. A retrospective chart review was performed in patients who had undergone these PPF reconstructions and who had received preoperative MRI. Preoperatively, the extent of infection and necrotic tissue was evaluated using MRI, and a reliable perforator was identified, considering the perforator location in relation to the defect, perforator size, and perforator courses. Intraoperatively, the targeted perforator was marked on the skin at the locations measured on the MRI images, and the marked location was confirmed using intraoperative handheld Doppler. Superior gluteal artery, inferior gluteal artery, or parasacral perforators were used for the PPFs. Surgical outcomes were evaluated. A total of 12 PPFs were performed in 12 patients. Superior gluteal artery perforator flaps were performed in 7 patients, inferior gluteal artery perforator flaps were performed in 3 patients, and parasacral perforator flaps were performed in 2 patients. We could identify a reliable perforator on MRI, and it was found at the predicted locations in all cases. There was only one case of partial flap necrosis. There was no recurrence of the pressure sores during the mean follow-up period of 6.7 months (range = 3-15 months). In selected patients with gluteal pressure sores, MRI is a suitable means for not only providing information about disease extent and comorbidities but also for evaluating perforators for PPF reconstructions.

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Use of Indocyanine Green Imaging for Perforator Identification in Preexpanded Brachial Artery Perforator Flaps

Facial Plastic Surgery ◽

10.1055/s-0040-1713791 ◽

2020 ◽

Vol 36 (05) ◽

pp. 650-658

Author(s):

Tinglu Han ◽

Nima Khavanin ◽

Mengqing Zang ◽

Shan Zhu ◽

Bo Chen ◽

...

Keyword(s):

Indocyanine Green ◽

Head And Neck ◽

Brachial Artery ◽

Donor Site ◽

Perforator Flap ◽

Donor Site Morbidity ◽

Icg Angiography ◽

Flap Design ◽

Flap Elevation ◽

Artery Perforator

AbstractThe tissues of the medial arm as a donor site for perforator flap design have several advantages. However, they are relatively underused with limited reports, partly due to unreliable perforator anatomy. Therefore, we aimed to review our preliminary experience using indocyanine green (ICG) angiography to design and elevate preexpanded pedicled brachial artery perforator (BAP) flaps for regional reconstruction. All patients underwent soft tissue reconstructions using a preexpanded BAP flap in two or three stages. ICG angiography was used to localize perforators during both expander insertion and flap elevation. The pedicle was divided at the third stage 3 weeks following flap elevation for head and neck cases. Sixteen patients underwent reconstructions of the head and neck (n = 13) or shoulder/trunk (n = 3) using 14 perforator-plus and 2 propeller BAP flaps. In total, 50 perforators were identified using ICG imaging, all of which were appreciable during both expander placement and flap elevation. Thirty-five perforators were directly visualized during flap elevation, and an additional 15 perforators were not explored but incorporated into the flap. All flaps survived without necrosis, and the donor sites healed uneventfully without complications. The medial arm provides thin and pliable skin for the resurfacing of regional defects with relatively minimal donor-site morbidity. With the assistance of ICG angiography, perforators of the brachial artery can be reliably identified, facilitating the preexpansion and elevation of pedicled BAP flaps for use in head–neck and trunk reconstruction.

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An assessment of the anatomical basis of the thoracoacromial artery perforator flap

Canadian Journal of Plastic Surgery ◽

10.1177/229255030301100102 ◽

2003 ◽

Vol 11 (1) ◽

pp. 23-27 ◽

Cited By ~ 17

Author(s):

Christopher Robert Geddes ◽

Maolin Tang ◽

Daping Yang ◽

Steven F Morris

Keyword(s):

Head And Neck ◽

Donor Site ◽

Perforator Flap ◽

Neck Region ◽

Donor Site Morbidity ◽

Pedicled Flap ◽

Perforator Flaps ◽

Thoracoacromial Artery ◽

Lateral Thoracic Artery ◽

Anatomical Basis

Background Musculocutaneous perforator flaps offer advantages over musculocutaneous flaps, including reduced donor site morbidity, more predictable reconstruction of soft tissue deformities, and a wider variety of flap options. Perforator flaps are becoming increasingly popular for many applications. In the present study, we set out to examine the various perforators of the thoracoacromial axis through the pectoralis major (PM) muscle with respect to their suitability for transfer to the head and neck region as a pedicled flap. Methods A series of 10 fresh cadavers were injected with lead oxide, gelatin and water (250 mL/kg) through the femoral vessels. The cadavers were cooled and the integument was removed. Perforating vessels from the underlying muscles were marked and the resulting angiograms of the integument and deep tissues were compared with the dissection notes describing the course, size and distribution of the perforating vessels. Results The perforators through the PM muscle to the overlying skin included three regional groups: perforators of the thoracoacromial axis; perforators of the medial intercostal vessels; and perforators of the lateral thoracic artery. The major group of perforators supplying the overlying skin was from the intercostal vessels. However, the thoracoacromial axis did consistently give rise to perforators in the upper portion of the PM muscle. In particular, there were reliable perforators from the clavicular and deltoid branches of the thoracoacromial artery. Discussion The present study illustrates the potential clinical applications of a series of perforator flaps based on the thoracoacromial axis, which may be useful in head and neck reconstructive surgery.

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Versatility of the Superficial Circumflex Iliac Artery Perforator Flap in Head and Neck Reconstruction

Annals of Plastic Surgery ◽

10.1097/sap.0b013e318260a3ad ◽

2014 ◽

Vol 72 (3) ◽

pp. 332-336 ◽

Cited By ~ 37

Author(s):

Takuya Iida ◽

Makoto Mihara ◽

Hidehiko Yoshimatsu ◽

Mitsunaga Narushima ◽

Isao Koshima

Keyword(s):

Head And Neck ◽

Iliac Artery ◽

Perforator Flap ◽

Head And Neck Reconstruction ◽

Neck Reconstruction ◽

Artery Perforator

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Minimally invasive soft tissue reconstruction with free peroneal artery perforator flap

Internal Medicine Review ◽

10.18103/imr.v2i8.173 ◽

2016 ◽

Vol 2 (8) ◽

Author(s):

Kenji Kawamura ◽

Hiroshi Yajima ◽

Shohei Omokawa ◽

Takamasa Shimizu ◽

Naoki Maegawa ◽

...

Keyword(s):

Soft Tissue ◽

Minimally Invasive ◽

Donor Site ◽

Perforator Flap ◽

Peroneal Artery ◽

Soft Tissue Reconstruction ◽

Perforator Flaps ◽

Major Vessel ◽

Tissue Reconstruction ◽

Artery Perforator

The development of a concept of perforator flap has dramatically changed the soft tissue reconstructive surgery. The surgery with perforator flaps enables to minimize donor-site morbidity by preserving important tissues including the muscle and the major vessel. The peroneal artery perforator flap is one of perforator flaps that can be harvested from the lower leg. The peroneal artery perforator flap has been widely used as a local flap for soft tissue reconstruction in the lower extremity; however, the free peroneal artery perforator flap transfer has been little reported. Utilities of the free peroneal artery perforator flap for soft tissue reconstruction of the extremities are reported, and minimally invasive flap surgery with perforator flaps is reviewed.

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