J Reconstr Microsurg 2011; 27(3): 195-198
DOI: 10.1055/s-0030-1270537
© Thieme Medical Publishers

Reconstruction of Pressure Sores with Perforator-Based Propeller Flaps

Rafael G. Jakubietz1 , Danni F. Jakubietz2 , Robert Zahn1 , Karsten Schmidt1 , Rainer H. Meffert1 , Michael G. Jakubietz1
  • 1Department of Trauma, Plastic, Reconstructive and Hand Surgery, University Hospital, Wuerzburg, Germany
  • 2Private Practice, Aesthetic Plastic Surgery, Erlangen, Germany
Further Information

Publication History

Publication Date:
23 December 2010 (online)


Perforator flaps have been successfully used for reconstruction of pressure sores. Although V-Y advancement flaps approximate debrided wound edges, perforator-based propeller flaps allow rotation of healthy tissue into the defect. Perforator-based propeller flaps were planned in 13 patients. Seven pressure sores were over the sacrum, five over the ischial tuberosity, and one on the tip of the scapula. Three patients were paraplegic, six were bedridden, and five were ambulatory. In three patients, no perforators were found. In 10 patients, propeller flaps were transferred. In two patients, total flap necrosis occurred, which was reconstructed with local advancement flaps. In two cases, a wound dehiscence occurred and had to be revised. One hematoma required evacuation. No further complications were noted. No recurrence at the flap site occurred. Local perforator flaps allow closure of pressure sores without harvesting muscle. The propeller version has the added benefit of transferring tissue from a distant site, avoiding reapproximation of original wound edges. Twisting of the pedicle may cause torsion and venous obstruction. This can be avoided by dissecting a pedicle of at least 3 cm. Propeller flaps are a safe option for soft tissue reconstruction of pressure sores.


Rafael G Jakubietz, M.D. 

Department of Trauma, Plastic, Reconstructive and Hand Surgery

University Hospital Wuerzburg, Oberduerrbacherstr 6, 97080 Wuerzburg, Germany

Email: Jakubietz_R@klinik.uni-wuerzburg.de