Experimental Animal Model Proving the Benefit of Primary Defatting of Full-Thickness Random-Pattern Skin Flaps by Suppressing “Perfusion Steal”

Chetboun, A.; Masquelet, A. C.

doi:10.1097/01.prs.0000282039.99450.9d

Cited by 17 publications

(7 citation statements)

References 14 publications

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“…[2][3][4]9,38 Furthermore, Chetboun and Masquelet stated that primary flap thinning was beneficial for distal perfusion, which was attributed to suppression of perfusion steal. 39 In addition, the flap pedicle could be divided comparatively early as superthin flaps, 5 to avoid stiffness of the upper extremity.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Study of Pectoral Intercostal Perforators and Clinical Study of the Pectoral Intercostal Perforator Flap for Hand Reconstruction

Oki

Murakami

Tanuma

et al. 2009

Plastic and Reconstructive Surgery

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Section: Discussionmentioning

confidence: 99%

Anatomical Study of Pectoral Intercostal Perforators and Clinical Study of the Pectoral Intercostal Perforator Flap for Hand Reconstruction

Oki

Murakami

Tanuma

et al. 2009

Plastic and Reconstructive Surgery

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“…23 The theoretical basis is that the fatty tissue under the proximal flap is beneficial to blood supply, but it's detrimental to the survival of flap under the distal part, according to the ''Perfusion Steal'' effect. 24 The thickness of the flap is similar to subdermal vascular network skin graft, but it provides a reliable blood supply through a vascular pedicle. 25 During the operation, we immediately removed the muscle and excess fat at the distal end of the flap to leave a thin layer of subcutaneous fatty tissue, through which the subdermal vascular network can be seen.…”

Section: Unilateral Pedicled Plus Contralateral Vascular Anastomosis ...mentioning

confidence: 99%

Different Transfer Forms of the Expanded Forehead Flap Pedicled With Superficial Temporal Vessels to Treat Chin and Submental Scar Deformities

Cao

Liu

Fan

et al. 2021

Journal of Craniofacial Surgery

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Background: The chin and submental regions are located at the junction of the face and neck. Its function and aesthetic appearance can be seriously affected when scar deformities cause the cervicomental angle to disappear. The expanded forehead flap pedicled with superficial temporal vessel(s) is a surgical treatment for chin and submental scar deformities. Different transfer types have developed for this flap based on individual situations. At present, there is no unified treatment strategy for applying this forehead flap to treat different regions and ranges of chin and submental scar deformities. Methods: Ninety one cases were collected from patients with chin and submental scar deformities that were treated using the expanded forehead flap pedicled with superficial temporal vessels from January 2008 to December 2018. The authors divided the chin and submental scar deformities into 4 types according to different regions and ranges, and summarized flap survival and complications of 5 different transfer forms used to treat scars for creating feasible treatment strategies. We followed up 76 cases, investigating the satisfaction of appearance and texture of the flaps, improvement of neck movement, and scar recurrence. Results: Expanded forehead flaps were used to repair 91 cases of chin and submental scar deformities. According to the postoperative flap survival and complications of flap blood supply, the treatment strategies are as follows: Bilateral cutaneous and subcutaneous pedicled forehead flaps are applied to treat scars in bilaterally symmetrical large-scale scars in Zone LCL. Unilateral pedicled forehead flaps are applied to treat small-scale scars in Zone C and Zone L. Unilateral pedicled plus contralateral vascular anastomosis and unilateral pedicled plus contralateral super thin forehead flaps are applied to treat the moderate-scale scars of Zone LC. Mean follow-up period was 81 months (range 28-131), 93.4% (71/76) was satisfied with appearance and texture of the flaps, 97.4% (74/ 76) was satisfied with the improvement of neck movement, and 2.6% (2/76) occurred scar recurrence. Conclusions: Five different types of expanded forehead flaps pedicled with superficial temporal vessels can be used to repair differential scar deformities of the chin and submental regions and achieve good therapeutic effects.

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“…modified to suit the needs of the recipient site, with defatting of the flap by removing the fat layer up to the dermis itself to make a "super-thin flap" or "subdermal vascular network flap," [21][22][23][24][25] or now even a pure skin perforator flap 26 with flap vascularity no longer dependent on the so-called subdermal plexus but the dermal plexus itself!…”

Section: Introductionmentioning

confidence: 99%

Perforator-Pedicled Propeller Flaps for Lower Extremity Reconstruction

2020

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Reconstruction of the lower extremity is considered a major challenge due to frequent bone exposure and the absence of local tissue redundancy, as well as often due to the presence of vascular insufficiency. Many surgeons have preferred free flaps especially for reconstructing the more distal lower limb defects until the evolution of pedicled perforator flaps and propeller flaps in particular provided a like-with-like reconstruction of the lower extremity without affecting the main vessels of the limb or the underlying muscles, and without the risk of any microanastomosis especially in patients with multiple comorbidities. Perforator-pedicled propeller flaps as local flaps in the lower extremity are best suited for small- and medium-sized defects with minimal donor-site morbidity, regardless of the cause of the defect. Any of the three source vessels of the leg can provide reliable perforators for propeller flap coverage of the distal leg and foot. The three main risk factors that are relative contraindications may be advanced age, diabetes mellitus, and atherosclerotic peripheral vascular disease.

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Experimental Animal Model Proving the Benefit of Primary Defatting of Full-Thickness Random-Pattern Skin Flaps by Suppressing “Perfusion Steal”

Cited by 17 publications

References 14 publications

Anatomical Study of Pectoral Intercostal Perforators and Clinical Study of the Pectoral Intercostal Perforator Flap for Hand Reconstruction

Anatomical Study of Pectoral Intercostal Perforators and Clinical Study of the Pectoral Intercostal Perforator Flap for Hand Reconstruction

Different Transfer Forms of the Expanded Forehead Flap Pedicled With Superficial Temporal Vessels to Treat Chin and Submental Scar Deformities

Perforator-Pedicled Propeller Flaps for Lower Extremity Reconstruction

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