The “Tokyo” Consensus on Propeller Flaps

Abstract

The propeller flap is a useful reconstructive tool that can achieve good cosmetic and functional results. A flap should be called a propeller flap only if it fulfils the definition above. The type of nourishing pedicle, the source vessel (when known), and the degree of skin island rotation should be specified for each flap.

Intercostal artery perforator propeller flap for reconstruction of trunk defects following sarcoma resection

“…In addition, the design of propeller flap uses a bridge segment of flap to cover the widest portion of the donor site, making the closure much easier. 23 In our series, dissection for more pedicle length within the costal groove was not needed. However, pedicle skeletonization was necessary to avoid any twisting or kinking.…”

True and 'Choke' Anastomoses between Perforator Angiosomes

“…4 This being said, there are case reports where a third or even fourth angiosome has been included in a flap, with survival of the flap in its entirety. [5][6][7][8][9][10][11][12][13] The underlying cause of this inconsistency in flap survival is indisputably related to the variation in the vascular connections between angiosomes. 4 These connections between angiosomes have been well described previously with cadaveric injection studies.…”

Closure of Complex Posterior Midline Defects After Spinal Surgery With Sensate Midline-based Perforator Flaps and the Long-term Results

“…According to the ''Tokyo'' consensus on propeller flaps, the MDICAP flap may be described as a perforator propeller flap. 30 Hyakusoku et al introduced the term ''propeller flap'' in 1991 to describe an adipocutaneous flap designed as a propeller with a pedicle in the center. 31 The perforator propeller flap is a flap designed with a skin island made of 2 paddles, 1 larger and 1 smaller, separated by the nourishing perforating vessel that corresponds to the pivot point.…”