The ‘propeller’ distal anteromedial thigh perforator flap. Anatomic study and clinical applications

Moscatiello, Fabrizio; Masià, Jaume; Carrera, Ana; Clavero, José Antonio; Larrañaga, Jose; Pons, Gemma

doi:10.1016/j.bjps.2007.02.027

Cited by 52 publications

(40 citation statements)

References 25 publications

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“…[22][23][24][25][26] Based on these studies and reports in the literature, perforator-based propeller flaps with a rotation up to 180°have shown to be viable and versatile. 2,3,8,9,21,27 In patients needing 180°of flap rotation, we attempt flap rotation in both a clockwise and counter-clockwise fashion. The rotation that results in less pedicle twisting is selected.…”

Section: Discussionmentioning

confidence: 99%

“…The rotation that results in less pedicle twisting is selected. 21 This is done before release of the tourniquet. When a rotation has been selected, we put the flap back in its native position.…”

Section: Discussionmentioning

confidence: 99%

“…In flaps that need to rotate 180°, it is a good idea to see which rotation (clockwise or counter-clockwise) results in a greater twisting or kinking of the pedicle and choose the appropriate direction of rotation. 21 If the flap is raised under tourniquet control, it is imperative to achieve excellent hemostasis, using bipolar cautery when the flap is raised. This will allow partial closure of the donor defect before the tourniquet is released.…”

Section: Flap Rotation and Insetmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Applications of Perforator-Based Propeller Flaps in Upper Limb Soft Tissue Reconstruction

Ono

Sebastin

Yazaki

et al. 2011

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Flap Rotation and Insetmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Applications of Perforator-Based Propeller Flaps in Upper Limb Soft Tissue Reconstruction

Ono

Sebastin

Yazaki

et al. 2011

The Journal of Hand Surgery

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“…The first two vessels are the easier ones on which the flap can be based [6]. The peripatellar region can also be covered by means of propeller flaps elevated from the distal anteromedial aspect of the thigh and nourished by perforator branches of the saphenous, femoral, and descending genicular artery [12]. Therefore, the propeller flaps may be employed in lower-limb reconstruction for a wide spectrum of clinical application, including posttraumatic defects, oncological resections, and postoperative wound dehiscence such as those that occur after fracture management, Achilles tendon surgery, and prosthetic knee replacement.…”

Section: Introductionmentioning

confidence: 99%

Perforator-based propeller flaps treating loss of substance in the lower limb

Tos¹,

Innocenti

Artiaco

et al. 2011

J Orthopaed Traumatol

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BackgroundLocal flaps based on perforator vessels are raising interest in reconstructive surgery of the limbs. These flaps allow efficient coverage of large wounds without the need to sacrifice a major vascular axis. The operative technique does not require microvascular anastomosis and allows reconstruction of soft tissue defects using nearby similar tissues. The aim of this study was to evaluate the clinical results of local perforator flaps in the treatment of complex lower-limb defects.Materials and methodsTwenty-two local perforator flaps were retrospectively studied. Loss of substance was due to postsurgical complications in seven cases, oncological resection in six, posttraumatic defect in five, pressure sores in three, and osteomyelitis in one.ResultsPostoperatively, two patients showed partial flap necrosis. In five patients, a superficial epidermolysis occurred. Minor complications were seen in three patients who showed transient venous congestion of the flap. Furthermore, transient leg edema was sometimes observed in patients with large propeller flaps. All but one patient healed without further major surgical procedures. In three cases, secondary skin grafts were performed. In most cases, the aesthetic result was optimal and patients were fully satisfied.ConclusionsWhen characteristics of the defect are suitable for treatment with a propeller-based local flap, this technique should be considered as one of reasonable options for surgical reconstruction. Microsurgical techniques facilitate the management of complex trauma in emergency and may allow planning reconstructive procedures and limb salvage in elective orthopedic surgery.

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“…[16] Moscatiello et al . [17] used skin islands from the distal anteromedial aspect of the thighs of six patients as local perforator flaps in order to reconstruct the peripatellar region and upper leg soft-tissue defects. They concluded that the propeller distal anteromedial thigh perforator flap can reliably be transferred based on the only one adequate perforator vessel, but the disadvantage is that it becomes a microsurgical technique where the dissection of the pedicle is performed by using binocular magnifying glasses.…”

Section: Discussionmentioning

confidence: 99%

Inferiorly based thigh flap for reconstruction of defects around the knee joint

Akhtar

Khan

Khurram

et al. 2014

Indian J Plast Surg

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Background:Soft-tissue defects around the knees are common in injured limbs and in the same injury the leg is often involved and the thigh is spared. Furthermore due to pliable and relatively lax skin, we have used inferiorly based thigh flap to reconstruct defects around knee joint.Aims and Objectives:The aim of this study is to evaluate the use of inferiorly based thigh flap to cover soft-tissue defects over the proximal one-third of the leg, patellar region, knee, and lower thigh.Materials and Methods:This study was conducted during the period between October 2011 and February 2013. Inferiorly based anteromedial thigh fasciocutaneous flap was performed on 12 patients and inferiorly based anterolateral thigh fasciocutaneous flap on four patients. The sites of the soft-tissue defects included patellar regions, infrapatellar region, upper one-third of leg, lower thigh, and over the knee joint.Results:Patients were evaluated post-operatively in terms of viability of flap, the matching of the flap with the recipient site, and donor site morbidity. All the flaps survived well except one which developed distal marginal flap loss, one in which wound dehiscence was noticed, and two in which mild venous congestion was observed. Venous congestion in two patients subsided on its own within 3 days. One patient with wound dehiscence achieved complete healing by secondary intention. Patient who developed distal flap loss required debridement and skin grafting. No appreciable donor site morbidity was encountered. Skin colour and texture of the flap matched well with the recipient site.Conclusions:The inferiorly based thigh flap is a reliable flap to cover the defect over proximal one-third of the leg, patellar region, knee, and lower thigh.

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The ‘propeller’ distal anteromedial thigh perforator flap. Anatomic study and clinical applications

Cited by 52 publications

References 25 publications

Clinical Applications of Perforator-Based Propeller Flaps in Upper Limb Soft Tissue Reconstruction

Clinical Applications of Perforator-Based Propeller Flaps in Upper Limb Soft Tissue Reconstruction

Perforator-based propeller flaps treating loss of substance in the lower limb

Inferiorly based thigh flap for reconstruction of defects around the knee joint

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