Preliminary Experience with Perforator Flaps in Reconstruction of Soft-Tissue Defects of the Foot and Ankle

Duffy, Frederick J.; Brodsky, James W.; Royer, Christian

doi:10.1177/107110070502600302

Cited by 27 publications

(23 citation statements)

References 23 publications

(19 reference statements)

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“…In recent years, the free perforator flaps started to be extensively used in diabetic foot ulcers (20, 44–46). Despite the high success rate of free microsurgical flaps (even in diabetic patients; (20, 44–48)), there are several drawbacks in using them including: the necessity of a well-controlled diabetic patient, longer anesthesia and operative time, distant donor site, necessity of good recipient vessels, and microsurgical skills.…”

Section: Discussionmentioning

confidence: 99%

The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

Georgescu

Matei

Capota

2012

Diabetic Foot & Ankle

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BackgroundPeripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin grafting (SG) with or without negative pressure wound therapy and local random flaps have been used with varying degrees of success to cover diabetic lower leg or foot ulcerations. Other methods include: local or regional muscle and fasciocutaneous flaps, free muscle and fasciocutaneous, or perforator flaps, which also have varying degrees of success.Patients and methodsThis article reviews 25 propeller perforator flaps (PPF) which were performed in 24 diabetic patients with acute and chronic wounds involving the foot and/or lower leg. These patients were admitted beween 2008 and 2011. Fifteen PPF were based on perforators from the peroneal artery, nine from the posterior tibial artery, and one from the anterior tibial artery.ResultsA primary healing rate (96%) was obtained in 18 (72%) cases. Revisional surgery and SG for skin necrosis was performed in six (24%) cases with one complete loss of the flap (4%) which led to a lower extremity amputation.ConclusionsThe purpose of this article is to review the use of PPF as an effective method for soft tissue coverage of the diabetic lower extremity and/or foot. In well-controlled diabetic patients that present with at least one permeable artery in the affected lower leg, the use of PPF may provide an alternative option for soft tissue reconstruction of acute and chronic diabetic wounds.

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Section: Discussionmentioning

confidence: 99%

The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

Georgescu

Matei

Capota

2012

Diabetic Foot & Ankle

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“…12 Muscle flaps covered by skin grafts undergo less predictable atrophy and thus it can be difficult to estimate the final contour. If contouring is required tangential excision of the muscle with reapplication of a skin graft is required.…”

Section: Discussionmentioning

confidence: 99%

“…However, adipocutaneous flaps are easily contoured with liposuction. 12 In addition to the range of tissues offered by the ALT donor site, the flap can be harvested from the ipsilateral leg, confining all surgery to the already injured leg and avoiding repositioning the patient intraoperatively. Furthermore, it can facilitate a two team approach to the reconstruction.…”

Section: Discussionmentioning

confidence: 99%

The Anterolateral Thigh Flap is Highly Effective for Reconstruction of Complex Lower Extremity Trauma

Park

Rodriguez

Bluebond-Langer

et al. 2007

The Journal of Trauma: Injury, Infection, and Critical Care

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“…Recently, DIEP flap also has been used widely for reconstruction of chest wall defect, maxillofacial reconstruction, foot reconstruction, and limb salvage of infected diabetic foot ulcers when used as a free flap. [13][14][15][16] As a pedicled flap, DIEP flap has been used in the repair of defects in the perineal and inguinal regions, as well as for vaginal reconstruction. [17][18][19][20] In summary, DIEP flap is representative of perforator flaps because it has the advantages of minimal donor site morbidity, direct closure of the donor site, long and constant vascular pedicle, and unchanged position of the patient during surgery.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Cicatricial Microstomia and Lower Facial Deformity by Windowed, Bipedicled Deep Inferior Epigastric Perforator Flap

Jin

Teng

Zhao

et al. 2009

Annals of Plastic Surgery

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We performed simultaneous facial scar repair and oral aperture open with a windowed, bilateral, bipedicled deep inferior epigastric perforator flap (DIEP flap) in a 20-year-old male patient who had suffered from severe postburn scar of the face and neck in association with serious cicatricial microstomia. DIEP flap is a typical perforator flap that has less donor site morbidity because of a minimal sacrifice of muscles. Since bipedicled DIEP flap can provide the largest skin territory in the lower abdominal wall and ensure a sufficient blood supply to zone IV, it is very suitable for the repair of massive defects of the face and neck. From our challenging case, we learned that bilateral, bipedicled DIEP flap is an excellent option for the repair of large faciocervical defects. Bilateral, bipedicled DIEP flap, which can produce an excellent esthetic and functional outcome, has reliable blood perfusion, provides soft and pliable tissue, and causes the minimal donor-site morbidity.

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Preliminary Experience with Perforator Flaps in Reconstruction of Soft-Tissue Defects of the Foot and Ankle

Cited by 27 publications

References 23 publications

The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

The Anterolateral Thigh Flap is Highly Effective for Reconstruction of Complex Lower Extremity Trauma

Reconstruction of Cicatricial Microstomia and Lower Facial Deformity by Windowed, Bipedicled Deep Inferior Epigastric Perforator Flap

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