A systematic review and <scp>meta‐analysis</scp> of perforator flaps in plantar defects: Risk analysis of complications

Zhang, Wei; Li, Xiaojing

doi:10.1111/iwj.13552

Cited by 6 publications

(7 citation statements)

References 49 publications

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“…limited tissue perfusion may be a result of damage in the macrocirculation or microcirculation. Diabetic patients are more prone to dangerous infections, rendering the healing of wounds more problematic and this also was reported by Zhang et al, in his study on perforator flaps [9].…”

Section: Discussionsupporting

confidence: 61%

Soft Tissue Reconstruction Around the Ankle with Peroneal and Posterior Tibial Artery Perforator Flaps: A Randomized Controlled Trial

Elshewy

El-Hadidy

Aziz

et al. 2022

The Egyptian Journal of Plastic and Reconstructive Surgery

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Background: Soft tissue defects of the ankle region continue to present a complex reconstructive challenge to the reconstructive surgeon. Many flaps have been used to rebuild these defects, and each flap has its own merits and drawbacks. This randomized controlled study was designed to compare between the peroneal artery perforator flap and the posterior tibial artery perforator flap for the ankle region reconstruction and finding out advantages and disadvantages of each flap.Methods: Between July 2020 and April 2022, 22 patients presented with soft tissue defects around the ankle with exposed vital structures as bones and tendons, who were categorized into two equal groups group 1: The peroneal artery perforator flap group (11 patients) and group 2: The posterior tibial artery perforator flap group (11 patients). Post-operative complications were the primary comparative parameters.Results: In total 22 patients with tissue defects around the ankle region were operated with either the peroneal artery perforator flap and the posterior tibial artery perforator flap 11 cases in each group, the post-operative flap complications as total flap loss and distal flap necrosis were (18.2%), (27.3%) receptively in the peroneal group and (27.3%), (36.4%) in the posterior tibial group and the mean time of flap elevation was longer in the posterior tibial group (106.82min) compared to the peroneal group with (64.55min). Conclusion:The peroneal artery perforator flap is better elevated as pedicled while the posterior tibial artery perforator flap better elevated as propeller.

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Section: Discussionsupporting

confidence: 61%

Soft Tissue Reconstruction Around the Ankle with Peroneal and Posterior Tibial Artery Perforator Flaps: A Randomized Controlled Trial

Elshewy

El-Hadidy

Aziz

et al. 2022

The Egyptian Journal of Plastic and Reconstructive Surgery

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“…On the contrary, Zhang et al . reported that a flap size greater than 50 cm 2 was associated with a higher postoperative complication rate [ 25 ]. Considerable perforator flap complications may be related to inadequate vascular supply; such an issue is problematic to many surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…Maintaining the donor site's aesthetic and normal function is also a struggle when a vast perforator flap is required. A large pedicled perforator flap donor site may be aesthetically acceptable in older patients with sagging skin; however, it may be unsightly in younger patients [ 12 , 25 ]. When the flap size is greater than 50 cm 2 , it is recommended that surgeons consider different treatment modalities, their experience, and the holistic assessment of the patient's condition.…”

Section: Discussionmentioning

confidence: 99%

Role of microsurgical free flap reconstruction in managing complex wound: a retrospective cross-sectional study

Altam¹,

Alsaaidi²,

Aljbri³

et al. 2022

Pan Afr Med J

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Introduction while reconstruction of complex wounds with severe tissue defects has been a significant problem in plastic surgery, free flap microsurgical procedures could solve many of these problems. In Yemen, data regarding free flap microsurgery for complex wounds are scarce. This study aimed to share our microsurgery experiences in repairing complex wounds using different free flaps in a resource-limited setting. Methods a retrospective cross-sectional study between April 2019 and June 2022 conducted at 21 University-affiliated hospitals included 30 patients with complex wound defects that were not amenable for regional, pedicle procedures, or skin grafts and underwent microsurgical reconstructions with deferent free flap tissue transfer. The primary outcome was flap survival or failure, while the secondary outcome was postoperative complications. Results the main age was 34.76 ± 16.88 years, with 24 (80%) males and 6 (20%) females. Replacing extensive tissue loss caused by road traffic accidents was the most common indication (36.6%). The mean defects required to be reconstructed were 84.9 ± 44.70 cm 2 . The lower extremities accounted for the majority of reconstructed defects (50%), and mostly (23.3%) involved the leg. Only 10 (33.3%) flaps were performed immediately within 48 hours of trauma. The fibulae osteo-cutaneous free flap (30.0%), radial forearms free flap (23.3%), and anterolateral thigh flap (23.3%) were used most commonly. All flaps were harvested and repaired under loupe magnification or operative microscope by a single surgeon. The overall flap success rate was 83.3%. The total complication rate was 23.3%, and postoperative infection and partial flap necrosis occurred in 3 (10.0%) and 2 (6.6%) patients, respectively. A total flap loss occurred in 5 (16.7%) patients. Conclusion reconstruction of complex wounds with microsurgical free flaps is a viable option even in a resource-limited setting. In our study, microsurgery with fibulae osteo-cutaneous free flap was the most commonly used. Despite many limitations, microsurgical free flaps were effective in treating individuals operated on in our setup with a limb salvage rate of 83.3%.

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“…However, the complications of nasolabial perforator flaps include postoperative congestion or ischemia, and some flaps require secondary debulking or pedicle division surgery. Previous studies have shown that Type 2 diabetes mellitus, elderly age, large flap size, and other factors can affect the blood supply of the flap in plantar reconstruction 1,2 . Currently, no studies have focused on identifying the risk factors of complications and secondary surgery with nasolabial perforator flaps in nasal reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Repair of Asian nasal subunit defects using nasolabial perforator flaps: A retrospective study

Lin,

Bu,

Yang

et al. 2023

J of Cosmetic Dermatology

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BackgroundThe application of nasolabial perforator flap for nasal reconstruction has been reported previously with satisfactory outcomes, but the outcomes and risk factors of postoperative adverse events have been unclear to plastic surgeons.AimsTo statistically analyze the effectiveness of the nasolabial perforator flap in nasal reconstruction and the risk factor of postoperative complications and re‐operation.Patients/MethodsThis retrospective study evaluated 58 Chinese patients who underwent nasal reconstruction with the nasolabial perforator flap from 2009 to 2021. The esthetic and blood supply outcomes were measured by plastic surgeons on a 5‐point Likert scale. Binary logistic regression was used to determine the risk factors associated with postoperative complications and re‐operation.ResultsThe mean age of the cohort was 66.4 ± 2.0 years. The defect size ranged from 6.5 × 5.5 mm2 to 40 × 70 mm2, and 48.3% of defects covered more than one nasal subunit. Venous congestion occurred in 4.9% of flaps, and the immediate overall postoperative score was 7.72/10. More than one nasal subunit of involvement was the risk factor associated with re‐operation (p = 0.004), but no risk factor was associated with complications.ConclusionsThe nasolabial perforator flap is reliable for nasal reconstruction with good esthetic outcomes and fewer complications. However, a large number of involved subunits may lead to multiple surgeries for flap trimming in easterners.

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A systematic review and meta‐analysis of perforator flaps in plantar defects: Risk analysis of complications

Cited by 6 publications

References 49 publications

Soft Tissue Reconstruction Around the Ankle with Peroneal and Posterior Tibial Artery Perforator Flaps: A Randomized Controlled Trial

Soft Tissue Reconstruction Around the Ankle with Peroneal and Posterior Tibial Artery Perforator Flaps: A Randomized Controlled Trial

Role of microsurgical free flap reconstruction in managing complex wound: a retrospective cross-sectional study

Repair of Asian nasal subunit defects using nasolabial perforator flaps: A retrospective study

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