Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Propeller Perforator Flaps in Distal Lower Leg: Evolution and Clinical Applications

  • Georgescu, Alexandru V. (Clinic of Plastic Surgery and Reconstructive Microsurgery, University of Medicine Iuliu Hatieganu)
  • Received : 2012.01.10
  • Accepted : 2012.02.01
  • Published : 2012.03.15
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Abstract

Simple or complex defects in the lower leg, and especially in its distal third, continue to be a challenging task for reconstructive surgeons. A variety of flaps were used in the attempt to achieve excellence in form and function. After a long evolution of the reconstructive methods, including random pattern flaps, axial pattern flaps, musculocutaneous flaps and fasciocutaneous flaps, the reappraisal of the works of Manchot and Salmon by Taylor and Palmer opened the era of perforator flaps. This era began in 1989, when Koshima and Soeda, and separately Kroll and Rosenfield described the first applications of such flaps. Perforator flaps, whether free or pedicled, gained a high popularity due to their main advantages: decreasing donor-site morbidity and improving aesthetic outcome. The use as local perforator flaps in lower leg was possible due to a better understanding of the cutaneous circulation, leg vascular anatomy, angiosome and perforasome concepts, as well as innovations in flaps design. This review will describe the evolution, anatomy, flap design, and technique of the main distally pedicled propeller perforator flaps used in the reconstruction of defects in the distal third of the lower leg and foot.

Keywords

References

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  22. Oncologic safety of propeller flap and free flap in reconstruction after soft tissue sarcoma resection vol.122, pp.4, 2012, https://doi.org/10.1002/jso.26076
  23. ZNF667 attenuates leukocyte‐endothelial adhesion via downregulation of P‐selectin in skin flap following remote limb ischemic preconditioning vol.45, pp.7, 2012, https://doi.org/10.1002/cbin.11586
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  25. Predictors of the surgical outcome of propeller perforator flap reconstruction, focusing on the effective safe distance between the perforator and the wound edge vol.22, pp.1, 2021, https://doi.org/10.1186/s12891-021-04522-z