Metatarsal artery perforator-based propeller flap

Abstract

Soft-tissue defects of the distal foot that involve an exposed tendon and bone demonstrate a reconstructive challenge for plastic surgeons. This report investigates the feasibility and reliability of metatarsal artery perforator (MAP)-based propeller flap for reconstruction of the distal foot soft-tissue defects. Between July 2011 and June 2012, six patients underwent distal foot reconstruction with seven MAP-based propeller flaps. Five flaps were based on the third metatarsal artery and two flaps were based on the first metatarsal artery. The flap size ranged from 4 × 2 cm to 8 × 4 cm. All flaps completely survived. Two patients developed transient distal venous congestion, which subsided spontaneously without complications. There were no donor site complications. All patients were ambulating without difficulty within the first month of surgery. MAP-based propeller flaps can be used to repair the distal foot soft-tissue defects, providing sufficient skin territory and excellent esthetic and functional recovery.

Risk Factor Analysis of Freestyle Propeller Flaps

“…Due to lack of remnant soft tissue around the flap harvest site in the extremities, additional skin graft to close the donor site is often needed. 19,39 In our study, 40% of propeller flaps harvested in the extremities required a skin graft for donor-site closure, while only 1 of 35 flaps from the trunk underwent local flap for donor-site closure and the other 34 were closed primarily. This high rate of skin grafting on the extremities not only burdens patients with additional donor-site morbidity, but also leads to aesthetically unpleasing appearance.…”

“…In the past few decades, pedicled perforator propeller flaps combined with the freestyle concept have gained greater popularity, which has increased options for reconstructive surgeons. The propeller flaps have been widely used in upper and lower extremities reconstruction, 6,10,[18][19][20][21][22][23] and more recently in trunk reconstruction. 9,15,24-26 Likewise, we have applied freestyle propeller concept throughout the body, as shown in this series.…”

Free versus perforator‐pedicled propeller flaps in lower extremity reconstruction: What is the safest coverage? A meta‐analysis

“…A total of 1,802 references of free flap were identified and we included 36 studies that discussed 1,226 free flaps used to treat 1,226 patients (Table ). For the pedicled‐propeller flap, a total of 616 references was identified and we included 19 studies . The 19 articles selected discussed 302 pedicled‐propeller flaps performed in 302 patients (Table ).…”

“…For the pedicled-propeller flap, a total of 616 references was identified and we included 19 studies. [49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] The 19 articles selected discussed 302 pedicled-propeller flaps performed in 302 patients ( Table 2).…”

Coverage of defect over toes after failure of microsurgical replantation with medial sural artery perforator flap: A case report

“…Skin grafting on the sole is not a good option in most cases due to weakness to the weight bearing stress and often leads to hyperkeratosis or chronic ulcers. Recently, pedicled flaps have been described for the distal foot area using perforator‐based propeller flap or changing the venous drainage, but local flaps are often questionable due to local trauma as well as limited reach to the distal toes and unreliability of flap circulation in some cases. Free tissue transfer techniques are free from this limitation when there are suitable recipient and donor vessels.…”