Lower Limb Perforator Propeller Flaps - Clinical Applications

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Lower Limb Perforator Propeller Flaps - Clinical Applications

R. Andrei, Ș.A. Popescu, D. Zamfirescu
General reports, no. 3, 2014
Background: A great variety of flaps have been used in lowerlimb reconstructive surgery: random pattern flaps, axial flapsand free microsurgical transfers with many variants. Afterfurther research on the cutaneous blood supply and improvementof microsurgical techniques, perforator propeller flapsbegan to be studied and used.Material and method: A propeller flap is defined as an insularflap mobilized through an axial rotation on a perforator pediclein order to cover a defect that has to be reconstructed.According to the specialized literature data and to the studieswe made on cadavers, this paper establishes a classificationbased on several criteria: 1) the position of the supplyingperforator; 2) the reconstructive necessities and the skin island;3) the flap blood supply; 4) the aesthetic and functionaldemands of the reconstructed areas. Based on this study weestablished the specific reconstructive indications for thesepropeller flaps.Conclusions: The reconstructive lower limb strategy allowsthe use of the perforator propeller flaps as first therapeuticoption for small and medium defects in certain areas considered as “critical”. Knowledge of the pedicle lengthand the surface of the flaps facilitates the optimum flapchoice in the reconstruction of a certain area.