Double Pedicled Perforator Flap to Close Flank Defects

Arco, Gunther; Horch, Raymund E.; Arkudas, Andreas; Dragu, Adrian; Bach, Alexander D.; Kneser, Ulrich

doi:10.1097/sap.0b013e318195361e

Cited by 21 publications

(4 citation statements)

References 9 publications

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“…The average level of evidence was 4.29, with 4 level 3 studies, 32 level 4 studies, and 20 level 5 studies. Multiple options for reconstruction were described including free style perforator flap, 3–9 lumbar artery perforator (LAP) flap, 6,8,10–12 paraspinous muscle flap, 2,13–17 SGAP, 10,14,18–22 inferior gluteal artery perforator, 19 intercostal artery perforator flap, 8,10,11,20,23,24 gluteus maximus musculocutaneous flap, 1,2,13,25–29 reverse latissimus dorsi flap, 2,7,13,27,30–35 lateral intercostal artery perforator–based latissimus dorsi flap, 36 external oblique musculocutaneous pedicled flap, 37 pedicled omental flap, 38–40 free flap, 7,13,14,41–55 and total leg flap. 56 The most frequently described method of lumbar wound reconstruction was free flap with 18 articles, followed by reverse latissimus dorsi flap reconstruction with 10 articles (Fig.…”

Section: Resultsmentioning

confidence: 99%

Reconstruction of Lumbar Spinal Defects: Case Series, Literature Review, and Treatment Algorithm

Daly

Ortíz

Shin

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background: Lumbar spinal defects present a distinct challenge for the reconstructive surgeon and are often complicated by previous spinal surgery, the presence of hardware, and prior radiation. There are a variety of reconstructive options described but no clear treatment algorithm for these challenging defects. Methods: A literature search was performed to review the described treatment options for lumbar spinal soft-tissue defects. Treatments for myelomeningocele or pressure ulcers were excluded. In addition, a retrospective case review was performed for patients with lumbar defects treated with pedicled superior gluteal artery perforator (SGAP) flap reconstruction. Results: A literature review revealed 2,022 articles pertaining to lumbar defect reconstruction, of which 56 met inclusion criteria. These articles described 13 individual reconstructive techniques for this anatomic area. The most commonly described techniques were evaluated and a treatment algorithm designed based on patient and wound characteristics. The clinical course of 5 patients with radiated lumbar spinal defects treated with SGAP flaps is presented. Conclusions: There are many treatment options for lumbar spinal defects and treatment should be tailored to the patient and the characteristics of the defect. For large or radiated lumbar wounds, the pedicled SGAP flap is an excellent reconstructive choice, as it has reliable anatomy that is outside the zone of injury, adequate bulk, and minimal donor-site deficits.

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Section: Resultsmentioning

confidence: 99%

Reconstruction of Lumbar Spinal Defects: Case Series, Literature Review, and Treatment Algorithm

Daly

Ortíz

Shin

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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“…In their cases, the type A chain-like variant was used to cover defects involving 2 different units of the hand, and the type B “kiss” pattern was required to resurface a large, single unit defect of the hand. Some other reports, such as “double-helix flap to close a massive circular soft-tissue defect,” [25] “multiple V-Y advancement and rotation flaps for a large cheek defect” [26] and “double pedicled perforator flap to close flank defects” [27] embody obvious elements of partition concept. What is more, some literature [28] had reported reconstruction of large defects with multiple pedicled flaps, but only case report, in which skin grafting also be used.…”

Section: Discussionmentioning

confidence: 99%

“…Review of literature shows a number of studies reconstructing large defect. [2–6] The various options available are skin grafting, artificial dermis, pedicled myocutaneous flaps, and free flaps. To date, a single all-round method has yet to emerge to deal with all sorts of wounds.…”

Section: Introductionmentioning

confidence: 99%

Multiple pedicled flaps cover for large defects following resection of malignant tumors with partition concept

Shen

et al. 2017

Medicine

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Large defects after skin malignant tumors resection were difficult to repair. We introduced a partition concept, in which the large defects were divided into several subunits, and each subunit was repaired by a certain pedicled flap to achieve a complete coverage.Between May 2012 and Oct 2016, 8 patients with skin malignant tumors underwent radical resection. Prior to surgery, the dimension of the potential defect after tumor ablation was estimated and outlined. After evaluation, the partition concept was applied and the defects were divided into several subunits. Also, the rationality of the choice of pedicled flap was evaluated. Each flap was used to cover its specific subunits defect.After excision, the defect areas were from 13 × 17 cm to 36 × 23 cm. Each subunit was designed to be repaired with a pedicled flap, which included local random flap, superficial iliac artery flap, transverse rectus abdominis myocutaneous (TRAM) flap, lateral thoracic advanced island flap, anterolateral thigh (ALT) flap, anteromedial thigh (AMT) flap, and deep circumflex iliac artery (DCIA) flap. Primary closure of both donor and recipient sites was achieved in all patients. All the flaps survived. Flap necrosis was not observed.Reconstruction of large defects following resection of malignant tumors with multiple pedicled flaps was a reliable method. The partition concept is useful in the reconstruction of large tumor wounds in 1-stage operation.

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“…52 D' Arpa et al noted that the longer length of perforators over the trunk permits a greater range of movement, allowing an extensive arc of rotation with little concern about the torsion of the perforator and the blood supply. Studies have demonstrated that large flaps with an orientation perpendicular to the longitudinal axis of the cutaneous dermatomes can be successfully transferred to the trunk 53 ( Fig. 5 ).…”

Section: Applicationsmentioning

confidence: 99%

Propeller Flaps

Panse

Karanjkar

2022

Indian J Plast Surg

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A propeller flap is an islanded flap that reaches the recipient site through an axial rotation around its vascular axis. The degree of rotation varies from 90 degrees to 180 degrees. It is a highly reliable local reconstructive option. These flaps are simple, single-stage, easy to harvest, and not constrained by routine length-to-width ratios. Since their introduction, the technique has continued to evolve and more applications for the use of propeller flaps are being explored. In spite of their growing use in clinical practice in recent years, many reconstructive surgeons are unaware of their versatility, unsure of their safety, and apprehensive about using propeller flaps confidently. This article aims at understanding the nomenclature, key principles, biogeometry and planning, operative technical details, applications, and complications of propeller flaps.

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Double Pedicled Perforator Flap to Close Flank Defects

Cited by 21 publications

References 9 publications

Reconstruction of Lumbar Spinal Defects: Case Series, Literature Review, and Treatment Algorithm

Reconstruction of Lumbar Spinal Defects: Case Series, Literature Review, and Treatment Algorithm

Multiple pedicled flaps cover for large defects following resection of malignant tumors with partition concept

Propeller Flaps

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