De-epithelialised turn-over flaps for “salvage” operations

The reconstruction of complex distal extremity defects is challenging with both cosmetic and functional considerations. This case series reviews our experience of using perforator-based flaps in 28 patients requiring reconstruction of 30 distal extremity defects. Hand held Doppler localisation of the perforators was carried out preoperatively in all cases. Flaps used were either fasciocutaneous or adipofascial and 90% of the defects were post-traumatic. Uncomplicated closure was achieved in 22 cases, with the majority of complications being minor. Complete failure was encountered in only two cases and as such was comparable with our experience of free tissue transfer. We propose consideration of perforator based flaps as an acceptable alternative to free tissue transfer in many extremity defects and find the hand held Doppler probe to be an invaluable tool in flap planning.

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“…2) uses a turnover method [9,10,20,21]. Again one or two dominant perforators are identified adjacent to the defect.…”

Section: Operative Techniquementioning

confidence: 99%

Perforator-based flaps in distal upper and lower extremity defects

2002

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“…[1] It was a simple concept to cover defects in any part of the body without the need for any sophisticated equipment. In the '80s, this flap was extensively used [2][3][4][5][6][7] to cover defects which were difficult to treat with flaps available at the time, with the exception of free flaps, which again, were not as commonly done in India at that time.…”

mentioning

confidence: 99%

Twenty years′ follow-up of a de-epithelialised turnover flap

Gopalakrishna

Kumar

2008

Indian J Plast Surg

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The authors have used the de-epithelialised turnover flap (Thatte′s Flap) for covering compound defects over the tendo-achilles in 31 patients in the period covering 1980-2000. Two of these patients have come up for follow-up after 20 years. In this late follow-up, the results are good and the tendon which was bridged by the dermis of the flap is functioning to allow the patients to stand on their toes. The de-epithelialised turnover flap is a simple and easy technique giving good long-term results. In spite of all the new advances in flap coverage, the de-epithelialised turnover flap is a good alternative for the tendo-achilles area in the armamentarium of a plastic surgeon.

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