Freestyle pedicled perforator flaps: safety, prevention of complications, and management based on 85 consecutive cases.

Salvatore D'Arpa, Francesco Moschella, Adriana Cordova, Salvatore D'Arpa, Francesco Moschella, Adriana Cordova, Marco Pignatti, Adriana Cordova

Risultato della ricerca: Articlepeer review

85 Citazioni (Scopus)

Abstract

Background: Despite the widespread use of free perforator flaps, pedicledperforator flaps seem not to be as widely accepted, probably because of the fearof vascular complications caused by transfer of a flap attached only by its vascularpedicle, prone to shearing, kinking, and trauma. In this article, the authorsreport 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 Plasticand Reconstructive Surgery Department of the University of Palermo for defectsof different causes that were reconstructed with a freestyle pedicled perforatorflap, in every region of the body, including the head and neck (41.2 percent),trunk (20 percent), upper limb (7.1 percent), and lower limb (31.8 percent).The majority of flaps (67.1 percent) were 180-degree propeller perforator flaps.Results: Complete flap survival was observed in 93 percent of cases. Six flaps (7percent) had vascular complications that were managed with venous supercharging(two cases), derotation (one case), conservative management (twocases), or secondary skin grafting (one case). The authors provide their approachto each situation to prevent or manage complications.Conclusions: The 93 percent success rate in this series seems to be acceptableand demonstrates that these flaps might be safely included in the authors’routine. If the flaps are appropriately planned and executed, with the suggestionsprovided in this article, some mistakes can be avoided to make these flapseven safer.
Lingua originaleEnglish
pagine (da-a)892-906
Numero di pagine15
RivistaPlastic and Reconstructive Surgery
Volume128
Stato di pubblicazionePublished - 2011

All Science Journal Classification (ASJC) codes

  • Surgery

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