The Use of Pedicled Perforator Flaps in Chest Reconstruction

Florczak, Anne-Sophie; Chaput, Benoît; Herlin, Christian; Rousseau, P.; Watier, Éric; Bertheuil, Nicolas

doi:10.1097/sap.0000000000001466

Cited by 11 publications

(2 citation statements)

References 57 publications

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“…In the axillary region, our review of 183 perforator propeller flaps showed a complication rate of 20.2%, with 37 complications. A meta-analysis by Florczak et al [ 81 ] showed an average complication rate of 9.9% for 182 flaps in the thoracic region. In the review by Lazzeri et al [ 82 ] on 288 propeller perforator flaps in the head and neck, trunk, and upper limb regions, the complication rate was 13.8%.…”

Section: Discussionmentioning

confidence: 99%

Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis

Vaillant

Berkane

Lupon

et al. 2022

JCM

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Introduction: Hidradenitis suppurativa (HS) is a common and debilitating disease, in which the only effective treatment involves a wide excision of the affected skin. Secondary wound healing and skin grafting are two well-known options for managing these defects, but perforator flaps provide a new therapeutic alternative by ensuring reconstructions of large defects, reducing donor site morbidity, and enhancing functional recovery. The aim of this study was to achieve a systematic review of perforator flaps use in HS. Patients and Methods: PubMed and Cochrane databases were searched from 1989 to 2021. The PRISMA statement was used in the study selection process and the review was registered on PROSPERO. Furthermore, patient characteristics, operative technique, complications, and recurrences were searched. Results: Thirty-six articles were selected including 286 patients and 387 flaps. Axillary localization was mostly represented (83.2%). Direct donor site closure was achieved in 99.1% of cases. In total, 15.1% of the flaps presented at least one of the following complications: wound dehiscence (5.5%), partial necrosis (2.9%), hematoma or seroma (2.1%), infection (2.1%), venous congestion (1.8%), and nerve injury (0.3%). Two cases of total necrosis were recorded. Recurrence of the disease was observed in 2.7% of the defects. Conclusions: Pedicled perforator flaps are a reliable and reproducible technique in the reconstruction of HS defects. They are associated with a low recurrence rate while ensuring an effective reconstruction with reduced morbidity and faster recovery compared to the techniques classically used in this indication.

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Section: Discussionmentioning

confidence: 99%

Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis

Vaillant

Berkane

Lupon

et al. 2022

JCM

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“…If still present, the venous congestion can be adequately managed with leech therapy (Herlin et al, 2017). In a previous teams works (Florczak et al, 2018) on PPF for chest wall defect, the SEAP flap had already been associated with a higher complication rate. As previously said, this can rely on intrinsic characteristics of the flap (caliber vessels, length of the pedicle, retrograde vessels flow after CABG), but also on specific characteristics of these patients (arterial disease, smoking status, ASA high score, etc.).…”

Section: Discussionmentioning

confidence: 94%

Superior epigastric artery perforator flap for reconstruction of deep sternal wound infection

et al. 2021

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Background The treatment of deep wound sternal infection requires loco‐regional pedicled flaps, usually with muscular flaps. Perforator propeller flaps represent the ultimate progress in the history of reconstructive surgery. We report here our experience with the superior epigastric artery perforator (SEAP) flaps to repair sternal defect. Patients and methods Six patients presenting deep sternal wounds infection were treated with SEAP propeller flap, between March 2015 and June 2017. The mean age was 71.5 (range 53–83) years. The mean length and width of the defect were 16.2 × 7 cm (ranging 8–20 × 4–10). An elliptical skin flap pedicled on the SEAP was harvested in the inframammary fold and rotated up to 90° to cover the defect. Results All SEAP flaps achieved a successful entire coverage of the defect. The mean size of the skin paddle of the flap was 20.2 × 7.3 cm (ranging 14–27 × 6–9). All flaps were able to provide a complete sternal wound cover. Venous congestion was present in five cases and adequately treated by leech therapy; necrosis was distal in one case, and interesting the entire superficial flap in two cases but with deep tissues remaining viable and able to cover the mediastinum: an infected flap required revision. Satisfyingly, at 2‐years postoperative follow‐up all‐patients were alive with a successful mediastinal cover. Conclusions The SEAP Perforator propeller flap is an alternative to muscle flaps to achieve treatment of deep and large sternal wound infection.

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Oncologic safety of propeller flap and free flap in reconstruction after soft tissue sarcoma resection

Gyu

Kang

Kim

et al. 2020

Journal of Surgical Oncology

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Background and ObjectivesThe propeller flap is a reliable option for reconstruction after soft tissue sarcoma resection. However, some parts of the resection margin may move away from its original position during flap rotation and thus can be excluded from the clinical target volume of adjuvant radiotherapy. This study aimed to evaluate local recurrence after soft tissue sarcoma resection with propeller flap or free flap reconstruction.MethodsPatients who underwent resection of soft tissue sarcoma followed by a free flap or propeller flap reconstruction and adjuvant radiotherapy at a single institution were retrospectively reviewed.ResultsThe 1‐ and 3‐year local control rates were 94.6% and 88.6% in the free flap group vs 90.6% and 87.5% in the propeller flap group, without statistical significance. There were no statistically significant differences in 5‐year local recurrence‐free survival (88.6% vs 87.5%) and disease‐free survival (82.5% vs 74.8%) between the groups.ConclusionsAlthough there was no significant difference in local control and disease‐free survival rates between propeller flap and free flap reconstruction after soft tissue sarcoma resection, a multidisciplinary approach is needed to obtain surgical information for determining the accurate clinical target volume of adjuvant radiotherapy and the area for meticulous follow‐up postoperatively.

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The Use of Pedicled Perforator Flaps in Chest Reconstruction

Cited by 11 publications

References 57 publications

Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis

Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis

Superior epigastric artery perforator flap for reconstruction of deep sternal wound infection

Oncologic safety of propeller flap and free flap in reconstruction after soft tissue sarcoma resection

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