Semin Plast Surg 2020; 34(03): 139-144
DOI: 10.1055/s-0040-1715158
Review Article

Our Definition of Propeller Flaps and Their Classification

Marco Pignatti
1  Department of Plastic Surgery, Policlinico di Sant'Orsola - DIMES, University of Bologna, Bologna, Italy
,
Rei Ogawa
2  Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
,
Musa Mateev
3  Department of Plastic Surgery, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
,
Alexandru V. Georgescu
4  Department of Plastic Surgery and Reconstructive Microsurgery, Clinical Hospital of Rehabilitation, University of Medicine Iuliu Hatieganu, Cluj-Napoca, Romania
,
Govindasamy Balakrishnan
5  Plastic, Hand & Microvascular Surgery, Right Hospitals, Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
,
Shimpei Ono
2  Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
,
Tania Cubison
6  Department of Plastic Surgery, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, United Kingdom
,
Valentina Pinto
1  Department of Plastic Surgery, Policlinico di Sant'Orsola - DIMES, University of Bologna, Bologna, Italy
,
Salvatore D'Arpa
7  Division of Plastic and Reconstructive Surgery, Department of Surgical, Oncological, and Oral Sciences (DICHIORONS), University of Palermo, Palermo, Italy
,
Isao Koshima
8  International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
,
Hiko Hyakusoku
2  Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
,
Geoffrey G. Hallock
9  Division of Plastic Surgery, Sacred Heart Campus, St. Luke's Hospital, Allentown, Pennsylvania
› Author Affiliations

Abstract

The term propeller flap was introduced for the first time by Hyakusoku to define an island flap, based on a subcutaneous pedicle hub, that was rotated 90 degrees to correct scar contractures due to burns. With the popularization of perforator flaps, the propeller movement was applied for the first time to a skin island vascularized only by an isolated perforator, and the terms propeller and perforator flap were used together. Thereafter, the surgical technique of propeller flaps evolved and new applications developed. With the “Tokyo consensus,” we proposed a definition and a classification schema for propeller flaps. A propeller flap was defined as an “island flap that reaches the recipient site through an axial rotation.” The classification included the SPP (SPP) flap, the perforator pedicled propeller (PPP) flap, and the supercharged PPP (SCP) flap. A recent update added a new category, the axial pedicled propeller (APP) flap. Here we propose our updated and comprehensive classification of propeller flaps, taking into account the previous classification and subsequent publications. Based on their vascular pedicle, we consider the following five types of propellers: (1) SPP flap, 2.PPP flap, its subtype (2a) SCP flap, (3) APP flap, (4) muscle propeller flap, and (5) chimeric propeller flap. The variables that can be taken into account in the classification are as follows: type of nourishing pedicle, degrees of skin island rotation, position of the nourishing pedicle, artery of origin of the pedicle, and flap shape.



Publication History

Publication Date:
22 September 2020 (online)

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