Free-Style Flaps: A Further Step Forward for Perforator Flap Surgery

Abstract

Potential pitfalls during free-style flap harvest can be avoided if the presented principles are adhered to. Newer imaging modalities may prove useful for assessing vessels supplying any cutaneous territory.

Predictable Pattern Digital Artery Perforator Flap

“…Thus, preoperative Doppler identification was not deemed necessary, while at the same time reconstructive surgeon disposes a wide choice of possibilities in the design of flaps. Subsequently, the principle of free-style perforator flaps 9,10,19,34,37 enriches, avoiding accuracy problems related to Doppler sonography. 1,24 The V-Y pattern has the inner problem of lesser mobility compared with the propeller flap.…”

Use of Perforator-Based Fasciocutaneous Flaps for Pressure Sore Reconstruction: Single-Perforator-Based Versus Multiple-Perforator-Based Flaps

“…The most important issues in perforator flap surgery are vascularity and flap perfusion. Taylor and Palmer reported in an angiosome study that more than 300 perforators with a diameter larger than 0.5 mm supplying the skin territory exist and that several perforators are present at the parasacral, gluteal, posterior thigh, and back areas for flap selection [8,27]. Regarding source artery selection in our procedure, similar to that in studies by Higgins et al and Kim et al [28,29], we used the flaps supplied by superior gluteal artery perforators for most of the sacral pressure sore reconstruction.…”

Clinical anatomical study and evaluation of the use of the free anteromedial thigh perforator flaps in reconstructions of the head and neck

“…There is no precise way to judge the amount of tissue that can be supplied by a vessel of a given size. 17 In this series of procedures, based on one sizeable perforator, a skin island of 18.5 cm × 7 cm was harvested safely. In our practice, the preferred method of calculating the dimension of the flap is to confirm perfusion of the flap margin after arterial anastomosis.…”