Free-Style Dual Plane Recycling Tensor Fascia Lata Musculocutaneous Perforator Flap for Reconstruction of Recurrent Trochanteric Defects

Abstract

Sequential flap coverage might be required for recurrent defects, but reusing a flap as a donor site has seldom been reported. The concept of a "free-style flap" has been developed, and it allows reconstructive surgeons to raise flaps with various designs reliably, even at sites of previous flap surgery. This article presents the concept of free-style recycling of a tensor fascia lata flap into a perforator-based flap separated in 2 planes in a patient with a recurrent bilateral trochanteric defect. If a reliable perforator is preserved and identified within the tissues by computed tomography angiography or a Doppler device, a new perforator flap can be designed and raised at the previous flap site.

Free-style puzzle flap as a cross-leg pedicled flap: the concept of re-using a flap in acute burns, a case report

“…The use of a previous redundant flap as a donor site is an interesting alternative in this situation [ 11 – 17 ]. Valauri et al [ 12 ] reported the case of a patient who sustained bilateral below-knee amputations that were treated with skin grafts as initial coverage.…”

The Marriage of Sartorius and Tensor Fasciae Latae in Treating Vascular Prosthetic Graft Infections

“…It derives its blood supply from the lateral circumflex nutrient artery, well documented for its reliability and consistency. 35–37 Traditionally, the flap is used for abdominal and trochanteric defects, 38–41 and generally its use is associated with little donor-site morbidity and loss of function. It is reported that the “safe dimensions” for the flap extends from the pedicle artery to 8–10 cm above the knee and should be no wider than 15 cm 29,42 ; however, Saito et al 43 required skin grafts to primarily close all 9 donor sites in their study, despite the flap being less than 10 cm in some of their patients.…”