scholarly journals Combined versus Single Perforator Propeller Flaps for Reconstruction of Large Soft Tissue Defects: A Retrospective Clinical Study

2022 ◽  
Vol 12 (1) ◽  
pp. 41
Author(s):  
Amir K. Bigdeli ◽  
Oliver Didzun ◽  
Benjamin Thomas ◽  
Leila Harhaus ◽  
Emre Gazyakan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Significant Risk ◽  
Operation Time ◽  
Soft Tissue Defects ◽  
Reliable Technique ◽  
Propeller Flap ◽  
Major Complications ◽  
Additional Surgery ◽  
Retrospective Clinical Study ◽  
Tissue Defects

Sufficient wound closure of large soft tissue defects remains a challenge for reconstructive surgeons. We aimed to investigate whether combined perforator propeller flaps (PPFs) are suitable to expand reconstructive options. Patients undergoing PPF reconstruction surgery between 2008 and 2021 were screened and evaluated retrospectively. Of 86 identified patients, 69 patients received one perforator propeller flap, while 17 patients underwent combined PPF reconstruction with multiple flaps. We chose major complications as our primary outcome and defined those as complications that required additional surgery. Postoperatively, 27 patients (31.4%) suffered major complications. The propeller flap size, the type of intervention as well as the operation time were not associated with a higher risk of major complications. A defect size larger than 100 cm2, however, was identified as a significant risk factor for major complications among single PPFs but not among combined PPFs (OR: 2.82, 95% CI: 1.01−8.36; p = 0.05 vs. OR: 0.30, 95% CI: 0.02−3.37; p = 0.32). In conclusion, combined PPFs proved to be a reliable technique and should be preferred over single PPFs in the reconstruction of large soft tissue defects at the trunk and proximal lower extremity.

scholarly journals Peroneal perforator pedicle propeller flap for lower leg soft tissue defect reconstruction: Clinical applications and treatment of venous congestion

2017 ◽  
Vol 45 (3) ◽  
pp. 1074-1089 ◽  
Author(s):  
Lifeng Shen ◽  
Yiyang Liu ◽  
Chun Zhang ◽  
Qiaofeng Guo ◽  
Wenhua Huang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Lower Leg ◽  
Soft Tissue Defect ◽  
Venous Congestion ◽  
Peroneal Artery ◽  
Soft Tissue Defects ◽  
Propeller Flap ◽  
Perforator Vessel ◽  
Tissue Defects

Objective To describe the characteristics of the perforator vessel in the peroneal artery of the lower leg and to explore the use of perforator pedicle propeller flaps to repair soft tissue defects in the lower leg, heel and foot. Methods This retrospective study enrolled patients with soft tissue defects of the distal lower leg, heel and foot who underwent surgery using peroneal perforator-based propeller flaps. The peroneal artery perforators were identified preoperatively by colour duplex Doppler ultrasound. The flap was designed based on the preoperatively-identified perforator location, with the posterior border of the fibula employed as an axis, and the perforator vessel as the pivot point of rotation. Patients were followed-up to determine the outcomes. Results The study analysed 36 patients (mean age, 39.7 years). The majority of the soft tissue defects were on the heel (20; 55.6%). The donor-site of the flap was closed in 11 patients by direct suturing and skin grafting was undertaken in 25 patients. Postoperative complications included venous congestion (nine patients), which was managed with delayed wound coverage and bleeding therapy. All wounds were eventually cured and the flaps were cosmetically acceptable. Conclusions The peroneal perforator pedicle propeller flap is an appropriate choice to repair soft tissue defects of the distal limbs.

scholarly journals Double-pedicle propeller flap for reconstruction of the foot and ankle: anatomical study and clinical applications

2019 ◽  
Vol 47 (10) ◽  
pp. 4775-4786 ◽  
Author(s):  
Jianxiong Zheng ◽  
Hua Liao ◽  
Jie Li ◽  
Lingjian Zhuo ◽  
Gaohong Ren ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Blood Supply ◽  
Sural Nerve ◽  
Anatomical Study ◽  
Peroneal Artery ◽  
Foot And Ankle ◽  
Soft Tissue Defects ◽  
Nerve Bundle ◽  
Propeller Flap ◽  
Tissue Defects

Objective Reconstruction of soft tissue defects in the foot and ankle remains challenging. This study was performed to investigate the technical points and clinical effects of a double-pedicle propeller flap for repair of foot and ankle soft tissue defects. Methods We used five fresh calf specimens to investigate the anatomical and operative aspects of a double-pedicle propeller flap. Eighteen patients with soft tissue defects in the foot and ankle subsequently underwent defect repair with double-pedicle propeller flaps. Results The anatomical study showed that the peroneal artery perforators and the sural nerve bundle (two blood supply systems) provided the theoretical anatomical basis for the double-pedicle propeller flap. The relative positions of the peroneal artery perforators and the sural nerve bundle differ according to the peroneal artery perforating level. Flap rotation in different directions can reduce or prevent the pedicles from compressing each other. All flaps survived, and three flaps developed local epidermal necrosis at the proximal end; these flaps healed after 1 to 2 weeks of dressing changes. The other 15 patients healed well. Conclusions The double-pedicle propeller flap can enhance the blood supply and venous return in the “big paddle” region of the flap, reducing the distal necrosis rate.

Perforator Propeller Flap for Oncologic Reconstruction of Soft Tissue Defects in Trunk and Extremities

2016 ◽  
Vol 77 (4) ◽  
pp. 456-463 ◽  
Author(s):  
Shengji Yu ◽  
Mengqing Zang ◽  
Libin Xu ◽  
Zhenguo Zhao ◽  
Xinxin Zhang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Propeller Flap ◽  
Tissue Defects

Reconstruction of soft tissue penile defects due to trauma using inguinal flaps

2021 ◽  
Author(s):  
Duc Hanh Nguyen
Keyword(s):  
Soft Tissue ◽  
Forearm Fracture ◽  
Operation Time ◽  
Functional Results ◽  
Optimal Choice ◽  
Pubic Bone ◽  
Corpus Spongiosum ◽  
Soft Tissue Defects ◽  
Urethral Injuries ◽  
Tissue Defects

Background: We present a case of using the external pudendal artery (EPA) flap to cover the soft tissue defects of the penis following multiple trauma with penis shrinkage, corpus spongiosum and urethral injuries. Case report: A 54-year-old male patient was admitted to the hospital with multiple injuries: complex trauma with extensive scrotal and perineal skin loss, soft tissue defects of the penis with corpus spongiosum and urethral injuries, complex and open forearm fracture. The patient underwent emergency surgery to remove scrotal skin, Burry the testis in the subcutaneous pouches in the thigh, Foley sonde was placed over the bladder above the pubic bone and amputate the right hand.After that, the patient was operated on using foreskin flaps to cover corpus spongiosum defects and reconstruct the urethra. However, after about 10 days, the foreskin flap was infected and then necrotic resulting in the soft tissue defects of the penis exposing the urethral.Therefore we decided to perform surgery using the external pudendal artery (EPA) flap to solve that problem. We put sonde foley to shallow urethra and let urine pass out. The cosmetic and functional results of this foreskin-flap have been good. There was no infection, the length of the penis was maintained. The urinary stream has been normal with no urine leakage after surgery. Conclusion: The external pudendal artery flap is a good option for the treatment of patients with penile soft tissue defects. Due to its simplicity, short operation time, easy dissection, good aesthetic outcome. Therefore the external pudendal artery flap is an optimal choice for the treatment of cases of genital soft tissue defects (scrota and penis).

Lower medial thigh perforator (LMTP) propeller flap for reconstruction of soft tissue defects around the knee

Microsurgery ◽  
2019 ◽  
Vol 40 (3) ◽  
pp. 298-305 ◽  
Author(s):  
Mario F. Scaglioni ◽  
Gabriele Giunta ◽  
Andrè A. Barth ◽  
Elmar Fritsche ◽  
Michael Arvanitakis
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Medial Thigh ◽  
Propeller Flap ◽  
Tissue Defects

Thoracic Propeller Perforator Flaps for Covering Soft Tissue Defects

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Matei Ileana ◽  
Alexandru Georgescu ◽  
Radu Lacatus ◽  
Manolis Daskalakis
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Tissue Defects
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