Semin Plast Surg 2020; 34(03): 200-206
DOI: 10.1055/s-0040-1715154
Review Article

Perforator-Pedicled Propeller Flaps for Lower Extremity Reconstruction

Mohamed A. Ellabban
1  Plastic and Reconstructive Surgery Unit, Suez Canal University Hospitals and Medical School, Ismailia, Egypt
,
Ahmed I. Awad
1  Plastic and Reconstructive Surgery Unit, Suez Canal University Hospitals and Medical School, Ismailia, Egypt
,
Geoffrey G. Hallock
2  Division of Plastic Surgery, St. Luke's Hospital – Sacred Heart Campus, Allentown, Pennsylvania
› Author Affiliations

Abstract

Reconstruction of the lower extremity is considered a major challenge due to frequent bone exposure and the absence of local tissue redundancy, as well as often due to the presence of vascular insufficiency. Many surgeons have preferred free flaps especially for reconstructing the more distal lower limb defects until the evolution of pedicled perforator flaps and propeller flaps in particular provided a like-with-like reconstruction of the lower extremity without affecting the main vessels of the limb or the underlying muscles, and without the risk of any microanastomosis especially in patients with multiple comorbidities. Perforator-pedicled propeller flaps as local flaps in the lower extremity are best suited for small- and medium-sized defects with minimal donor-site morbidity, regardless of the cause of the defect. Any of the three source vessels of the leg can provide reliable perforators for propeller flap coverage of the distal leg and foot. The three main risk factors that are relative contraindications may be advanced age, diabetes mellitus, and atherosclerotic peripheral vascular disease.



Publication History

Publication Date:
22 September 2020 (online)

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