Inferior epigastric artery skin flaps without rectus abdominis muscle

Koshima, Isao; Soeda, Shinji

doi:10.1016/0007-1226(89)90075-1

Cited by 1,041 publications

(481 citation statements)

References 6 publications

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“…This can be by identifying extra perforators or veins for use as a means of turbo-charging a flap or to convert the pedicle flap into a free flap. Ever since the first publication by Koshima and Soeda [4] in 1986, there have been several publications on the use of perforator flaps for reconstruction of a multitude of defects. The lower extremity seems to be a region of interest as it represents a new paradigm shift in management.…”

Section: Discussionmentioning

confidence: 99%

“…These flaps however introduced morbidity of muscle loss, and insufficient reach to the distal third of the leg. Advances in techniques of flap harvest gave birth to perforator flaps through the innovative work by Koshima and Soeda [4]. Several designs and movement of perforator flaps have been designed by various authors amongst which are the keystone flap and the propeller Results: All the patients tolerated the procedure well.…”

Section: Introductionmentioning

confidence: 99%

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Propeller Flaps in Lower Limb Reconstruction: Case Series

Sasidaran¹

2013

Anaplastology

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Introduction: Traditionally in reconstruction of lower limb soft tissue defects, muscle flaps have been the 'Gold Standard' for Gustillo Anderson Grade III B fracture involving upper and middle third defects. Lower third defects were usually reconstructed with free flaps. Evolution in flap surgery has enabled fasciocutaneous, adipofascial and superthin flaps to be harvested for the purpose of reconstruction thereby minimizing morbidity from muscle inclusion into the flap. We present our experience with perforator (propeller) flaps for reconstruction of soft tissue defects in the lower limb. Materials and methods:Between February 2010 and April 2010, 6 consecutive patients, 34 years (18-50 years old), were referred to our services post trauma to the lower extremity. This case series consists of patients from two separate centers in Malaysia. All wounds were classified as Gustillo Anderson Grade IIIB. All patients were operated under spinal anaesthesia. Perforators were identified and traced to major limb vessel and skin paddle was designed around the perforator. Skin paddle was then rotated into the defect in the lower third of the leg.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Propeller Flaps in Lower Limb Reconstruction: Case Series

Sasidaran¹

2013

Anaplastology

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“…The advantage of double free flap transplantations from the same site is low donor site morbidity. In other flaps, such as a deep inferior epigastric artery perforator flap [3], a thoracodorsal artery perforator flap [4], and a tensor fasciae latae perforator flap [5], the perforators are too closely located to each other to allow elevation of the two flaps. Moreover, a groin flap has one dominant perforator [6], so it can-not provide two flaps.…”

Section: Discussionmentioning

confidence: 99%

A Case of Harvesting Anterolateral Thigh Flaps Twice from the Ipsilateral Thigh of a Single Patient in Separate Operations

Saito¹,

Kimura²,

Okochi³

et al. 2016

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Until now, harvesting of flap elevations from the ipsilateral thigh twice in the same patient in two operations has not been reported. We harvested thigh flaps twice from the ipsilateral thigh of a single patient in separate operations. A 44-year-old man had skin defects of the right thumb and the left middle finger. In the first operation, his right thumb was reconstructed by the hemi-pulp flap. The anterolateral thigh flap harvested from the left thigh transferred to the donor site defect of the hemi-pulp flap. Sixteen days after the first operation, another anterolateral thigh flap harvested from the left thigh transferred to the defect of the left middle finger. This operative procedure is very useful for cases requiring multi-flap transfer.

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“…In the new millennium, we have resurrected the anatomy phase with the development of perforator flaps. The development of the DIEP followed by SGAP and subsequent perforator flaps has created a new phase of microsurgery [2,[13][14][15][16][17]. The next phase would seem to be poised for that of allotransplantation [18].…”

Section: Introductionmentioning

confidence: 99%

Anatomy of Free Flap Failures: Dissection of a Series

Davison¹,

Clemens²,

Kochuba³

2013

MPS

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Introduction: Free flap success rates have remained stable in recent years ranging 93% to 98%. Historically, the causes of free flap failures were attributed to the surgeon's inexperience and technique. However, there are factors beyond the surgical anastomosis that contribute to flap failure. The purpose of this study is to review each case of total flap loss in detail to develop a better understanding of complications. Methods: A retrospective study was performed over eleven years in a single surgeon's practice, a predominantly head and neck reconstructive practice. All charts were independently reviewed. In patients who sustained total flap loss, a review was conducted of patient comorbidites, anesthesia records, perioperative and follow-up notes. Results: A total of 514 free flaps were performed. 76% (392) of these flaps were for head and neck reconstruction. There were 22 total flap losses (4%) and 26 partial flap losses (5%). Of the 22 total flap losses, four flaps were avulsed, five flaps were in patients later found to have coagulation disorders (homozygous mutations of the MTHFR gene and factor V Leiden), four patients were exposed to neosynephrine, two patients remained hypotensive perioperatively, and four delayed flap losses were attributed to pseudomonal infection. Five losses were technical or related to flap inexperience. Several representative case scenarios are illustrated. Conclusion: Careful review of free flap failures indicates that a thorough workup (particularly coagulation disorders), flap selection, surgeon to anesthesia communication, proper securing of the flap, and postoperative patient blood pressure and infection control have a greater part to play in this new era of anastomotic success.

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Inferior epigastric artery skin flaps without rectus abdominis muscle

Cited by 1,041 publications

References 6 publications

Propeller Flaps in Lower Limb Reconstruction: Case Series

Propeller Flaps in Lower Limb Reconstruction: Case Series

A Case of Harvesting Anterolateral Thigh Flaps Twice from the Ipsilateral Thigh of a Single Patient in Separate Operations

Anatomy of Free Flap Failures: Dissection of a Series

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