A review and critical appraisal of central axis flaps in axillary and elbow contractures

Karki, Durga; Ahuja, Rajeev

doi:10.1186/s41038-017-0079-7

Cited by 3 publications

(1 citation statement)

References 40 publications

(57 reference statements)

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“…1 Several variations of this technique may be applied to better optimize the result. [28][29][30] The perineum is another region where this subtype of propeller flap is most useful as exemplified by the "lotus flaps." 31 In some instances, propeller flaps of the facial artery are also better raised with this technique, especially when the arterial perforator and the venous perforator lie at some distance from one another, as is characteristic.…”

Section: Subcutaneous Pedicle Propeller Flapsmentioning

confidence: 99%

Our Definition of Propeller Flaps and Their Classification

et al. 2020

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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.

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Section: Subcutaneous Pedicle Propeller Flapsmentioning

confidence: 99%

Our Definition of Propeller Flaps and Their Classification

et al. 2020

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Preexpanded Brachial Artery Perforator Propeller Flap: An Addition to the Armamentarium for Postburn Axillary Contracture Reconstruction

Wang,

Li,

Zhou

et al. 2024

Plastic &Amp; Reconstructive Surgery

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Background: Postburn axillary contracture is a common complication that leads to functional impairment and unsatisfactory aesthetic outcomes. This article aims to present our experience with axillary contracture reconstruction using pre-expanded brachial artery perforator propeller (BAPP) flaps and provide a systematic review of other regional or free flaps. Methods: This retrospective study included patients who underwent postburn axillary contracture reconstruction using pre-expanded BAPP flaps from 2015 to 2022. Data on the flap characteristics and function of the affected shoulders were recorded. A systematic review was conducted by retrieving studies that assessed the outcomes of regional or free cutaneous/fasciocutaneous flaps for treating axillary contracture from PubMed, Web of Science, EMBASE, and Scopus published before October 1, 2023. Results: Twelve pre-expanded BAPP flaps measuring up to 26 cm × 11 cm (mean, 116.9 cm 2) survived completely with no major complications, and the donor sites were closed primarily. The average range of shoulder abduction increased from 77.9° to 141.7° (p=0.002). The systematic review included 34 articles, reporting 12 regional and three free flaps. The most reported flaps were the thoracodorsal artery perforator flap, scapular flap, and parascapular flap. The overall complication rate ranged from 0 to 25%, and the average change in shoulder abduction ranged from 72.5° to 99.4°. Conclusions: Pre-expanded BAPP flaps can be effectively used for reconstructing postburn anterior axillary fold contracture. The donor site availability and the specific axillary contracture type should be considered when selecting a regional or free flap.

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Management of postburn axillary contractures

Ahuja

Chatterjee

2019

Indian J Burns

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A review and critical appraisal of central axis flaps in axillary and elbow contractures

Cited by 3 publications

References 40 publications

Our Definition of Propeller Flaps and Their Classification

Our Definition of Propeller Flaps and Their Classification

Preexpanded Brachial Artery Perforator Propeller Flap: An Addition to the Armamentarium for Postburn Axillary Contracture Reconstruction

Management of postburn axillary contractures

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