Search results for "perforator flaps"
showing 10 items of 16 documents
Freestyle pedicled perforator flaps: safety, prevention of complications, and management based on 85 consecutive cases.
2011
Background: Despite the widespread use of free perforator flaps, pedicled perforator flaps seem not to be as widely accepted, probably because of the fear of vascular complications caused by transfer of a flap attached only by its vascular pedicle, prone to shearing, kinking, and trauma. In this article, the authors report on their experience with 85 consecutive cases, focusing on incidence, prevention, and management of complications. Methods: Eighty-five consecutive cases were treated over 6 years at the Plastic and Reconstructive Surgery Department of the University of Palermo for defects of different causes that were reconstructed with a freestyle pedicled perforator flap, in every regi…
Retrospective Analysis in Lower Limb Reconstruction: Propeller Perforator Flaps versus Free Flaps.
2017
Background Technical advancements and increasing experience in the management of soft tissue defects in lower extremities have led to the evolution of decisional reconstructive algorithms. Both propeller perforator flaps (PPFs) and free flaps (FFs) proved to be useful methods of reconstruction for lower extremities defects, offering alternative reconstructive tools. We present a case series of PPFs and FFs for reconstruction of lower limbs defects, analyzing and comparing treatment and outcomes. Methods Through a retrospective analysis, we report our experience in performing PPFs or FFs for reconstruction of soft tissue defects of the lower extremities, in patients admitted between 2010 an…
A new mucosal propeller flap (Deep Lingual Artery Axial Propeller): The renaissance of lingual flaps
2015
BACKGROUND: Lingual flaps provide ideal mucosal coverage for intraoral defects but traditionally require two surgical stages. The authors present an axial mucosal propeller flap for single-stage intraoral reconstruction. The flap includes the mucosa of the lateral side of the tongue, islanded on the deep lingual vessels. METHODS: Between 2011 and 2013, 23 patients underwent intraoral mucosal reconstruction with a deep lingual artery axial propeller flap after cancer resection in the cheek (n = 16), floor of the mouth (n = 2), retromolar trigone (n = 2), hard palate (n = 2), and soft palate (n = 1). Mean defect size was 19.5 cm. Preoperative and postoperative intraoral function was evaluated…
A New Technique for Coronaplasty in Penile Reconstruction.
2018
Abstract Background The coronaplasty is an important step of the phalloplasty procedure as it creates a prominent coronal ridge and a constricted coronal sulcus, resulting in the transformation of a regular skin flap into a flap resembling a circumcised penis. Aim The aim of this article is to describe our new coronaplasty technique that exploits opposing contracting forces of 2 different skin grafts to hold the shape of a thick, distally based skin flap, resulting in a natural looking neo-phallus. Methods A distally based flap is raised at the junction of the middle and distal thirds of the neo-phallus. The dissection continues until adequate mobilization is obtained, so the flap can stand…
Propeller Flaps: A Review of Indications, Technique, and Results
2014
In the last years, propeller flaps have become an appealing option for coverage of a large range of defects. Besides having a more reliable vascular pedicle than traditional flap, propeller flaps allow for great freedom in design and for wide mobilization that extend the possibility of reconstructing difficult wounds with local tissues and minimal donor-site morbidity. They also allow one-stage reconstruction of defects that usually require multiple procedures. Harvesting of a propeller flap requires accurate patient selection, preoperative planning, and dissection technique. Complication rate can be kept low, provided that potential problems are prevented, promptly recognized, and adequate…
The effects of optimizing blood inflow in the pedicle on perforator flap survival: A pilot study in a rat model
2020
Background Perforator flaps have led to a revolution in reconstructive surgery by reducing donor site morbidity. However, many surgeons have witnessed partial flap necrosis. Experimental methods to increase inflow have relied on adding a separate pedicle to the flap. The aim of our study was to experimentally determine whether increasing blood flow in the perforator pedicle itself could benefit flap survival. Methods In 30 male Lewis rats, an extended posterior thigh perforator flap was elevated and the pedicle was dissected to its origin from the femoral vessels. The rats were assigned to three groups: control (group I), acute inflow (group II) and arterial preconditioning (group III) dep…
Pedicled Flaps for Anterior Chest Wall Reconstruction
2020
Pedicled local or regional flaps are the main reconstructive tool for chest wall defects. Muscle or musculocutaneous flaps are most commonly used, with the latissimus dorsi and the pectoralis major being the workhorse flaps. However, perforator flaps have recently affirmed even for reconstruction of complex defects. A thorough knowledge of the vascular anatomy of the thorax and of the patient’s medical history is essential for selecting the best reconstructive option. The defect location, size, and depth as well as previous surgeries in the same area are the main issues affecting the reconstructive choices.
ALGORITHM OF PARTIAL BREAST RECONSTRUCTION WITH PEDICLED PERFORATOR FLAPS
2010
INTRODUCTION: The authors present an algorithm of partial breast reconstruction following quadrantectomy that allows to restore the breast volume defect with the use of pedicled perforator flaps. MATERIAL AND METHODS: Between March 2009 and May 2010, at the Plastic and Reconstructive Institute of University of Palermo, pedicled perforator flaps were used to integrate volume and/or breast skin in 12 patients after benign and malignant breast tumors. The flaps used were based on perforators of the thoraco-dorsal artery (TDAP) and of the intercostal arteries (ICAP). TDAP flaps were used to reconstruct defects in any breast quadrant, while ICAP perforator were used to reconstruct lateral and ce…
Novel fasciocutaneous flaps for the reconstruction of complicated lower extremity wounds
2009
Summary: Reconstruction of the leg is particularly challenging especially when the defect involves its lower third. The options for lower leg reconstruction are very few because of the lack of local soft tissue available for transfer. Novel fasciocutaneous flaps nourished by perforator vessels have been developed and are increasingly used as a valuable local alternative to the local flaps, with their high complication rates, and to the microsurgical flaps, with their more difficult and specialized technique. They provide local tissue, replacing like with like, but they harvest it from a distant, undamaged, region of the leg, which means healthy and well-vascularized tissue. They do not need…
A sequence of flaps and dissection exercises in the living model to improve the learning curve for perforator flap surgery.
2020
Abstract Introduction The training to learn how to perform perforator flaps requires practice on a living model to optimize dissection and to evaluate outcome. The purpose of this study was to describe a training model that optimizes the use of animals in order to perform the maximum number of exercises per animal. Material and methods The sequence has been planned and practiced by the first and last author, recorded perfected and implemented in a two-day surgical course. The sequence was then evaluated by the trainers and the trainees by means of a questionnaire. Results All students were able to complete the sequence of exercises before the end of the second day except two (8/10) who coul…