Thoracic Propeller Perforator Flaps for Covering Soft Tissue Defects

Introduction: It is well known that there are a lot of possibilities for covering soft tissue defects in the anterior and posterior thoracic region, from local random advancement flaps, to free flaps and perforator flaps. We present our series of propeller perforator flaps used in covering soft tissue defect of the thoracic region.

Methodology and Material: The 11 cases in our series included patients with oncologic pathologies of the anterior or posterior thoracic wall, which, after excision of the tumor needed soft tissue covering for medium and large tissue defects.

As demonstrated by other studies and also by our vascular studies, there are some very good perforators emerging from the thoracodorsal, lateral thoracic and intercostals vessels, which can blood supply viable perforator flaps. In our studies, experimental in vivo in pigs and using hand held Doppler, we found them to be quite reliable and able to support harvesting and displacing large quantities of regional soft tissue.

The patients were all males, aged between 45 and 63 years old, and the flaps were between 32/28 cm and 20/10 cm in the largest dimensions.

In all but one case the tumors did not invaded the thoracic bones, and distant metastases were absent.

Results: All the flaps were viable, and in only one case we noted a delayed healing in the distal region of the flap.

Conclusions: Based on the study of literature and by our own studies and clinical series, we can consider that the thoracic perforator propeller flaps are viable instruments in the armamentarium of reconstructive surgeons.