Free-Style Free Flaps

Wei, Fu‐Chan; Mardini, Samir

doi:10.1097/01.prs.0000133171.65075.81

Cited by 327 publications

(190 citation statements)

References 40 publications

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“…Every single perforator can be a blood supply to a skin flap. Based on the concept of free style flap, 14 ICAP flaps can be harvested to cover defects that extend on the trunk from the lower neck to lower abdomen and lumbosacral area. In this series, we described the surgical technique and new indications for ICAP pedicled flaps.…”

Section: Discussionmentioning

confidence: 99%

The versatility of the inter-costal artery perforator (ICAP) flaps

Hamdi

Landuyt

Frene

et al. 2006

Journal of Plastic, Reconstructive & Aesthetic Surgery

231

174

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Summary Introduction: Anatomy and classification of intercostal perforator flaps in addition to our experience with will be demonstrated for different indications. Material and methods: The intercostal vessels form an arcade between the aorta and the internal mammary vessels. Different pedicled perforator flaps can be raised on this neurovascular bundle to cover defects on the trunk. They are classified as following: dorsal intercostal artery perforator flap (DICAP); lateral intercostal artery perforator (LICAP); and anterior intercostal artery perforator (AICAP) flap. Results: Between 2001 and 2004, 20 pedicled (ICAP) flaps were harvested in 16 patients. The indications were: immediate partial breast reconstruction in eight patients who had a quadrantectomy for breast cancer; midline back and sternal defects in three patients who had radical excisions for a dermatofibrosarcoma or malignant melanoma; and autologous breast augmentation (four bilateral and one unilateral flap) in five post-bariatric-surgery patients. The average flap dimension was 18!8 cm 2 (range 8!5-24!12 cm 2 ). There were two DICAP flaps, two (AICAP) flaps and 16 (LICAP) flaps. All but two flaps were based on one perforator. Mean harvesting time was 45 min for a single flap. Bilateral breast augmentation with LICAP flap necessitated longer operative time (range 2-3 h) depending whether it was combined or not with mastopoexy. Complete flaps survival was obtained. All donor sites were closed primarily. Conclusion: The (ICAP) flaps provide valuable options in breast surgery; and for challenging defects on the trunk without sacrifice of the underlying muscle.

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Section: Discussionmentioning

confidence: 99%

The versatility of the inter-costal artery perforator (ICAP) flaps

Hamdi

Landuyt

Frene

et al. 2006

Journal of Plastic, Reconstructive & Aesthetic Surgery

231

174

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“…Later on Wei and Mardini 22,35 with their pioneering work introduced the concept of free-style perforator flaps, opening a new dimension in this recent field. A hand-held Doppler device allowed mapping of any clinically significant perforating vessels in every region of the human body offering limitless possibilities to the reconstructive surgeon.…”

Section: Introductionmentioning

confidence: 99%

Predictable Pattern Digital Artery Perforator Flap

Kostopoulos

Agiannidis

Konofaos

et al. 2016

Hand (New York, N,Y.)

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Background: The proper digital arteries as any other axial vessel give rise to multiple cutaneous perforators either volar or dorsal along their course. Their identification is performed with Doppler flowmetry. The vasculo-cutanotendino-osseous complex (VCTOC), which was described by the senior authors, was responsible for the vascularization of all digital anatomic structures (extensor apparatus, skin, periosteum). Their consistent appearance to well measured distances from the digital joints led the way to the present clinical study for highlighting this described anatomy in-vivo and demonstrating the predictability in digital artery perforator (DAP) flap harvest. Methods: From November 2012 to March 2014, fifteen patients underwent reconstruction with a predictable pattern digital artery perforator flap (PPDAP), based on the previously described VCTOC mapping, for digital lesions secondary to tumor extirpation. Flaps were designed as V-Y advancement or propeller type. Postoperative control concerned flap viability and digital function. Results: Seven males and 8 females underwent elective surgery using PPDAP flaps for digital defects following tumor extirpation. The diameter of the defect ranged from 0.5 to 1.5 cm. The vast majority of the lesions were identified on the right hand, the index, the ring finger and the distal phalanx. All flaps survived without signs of venous congestion. No functional digital problems were observed during follow up (mean of 77 months). A minor wound dehiscence presented in one patient. Conclusions: Authors introduced the concept of a "predictable pattern" in the surgery of perforator flaps in the digits. These flaps are reliable and could be a valuable reconstructive option.

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“…In clinical practice, a ''loud'' signal should be chosen over a ''soft'' signal. 22,23 Although Doppler ultrasonography is a reliable technique to aid in identification of the perforating vessels in general, 22,23 we have found in our experience with the ALT that the reliability decreases significantly with the increase of body mass index, which differs markedly between Asian and Western populations. With thicker subcutaneous fat, the course and destination of the perforators become distorted, thus increasing the margin for error.…”

Section: Discussionmentioning

confidence: 84%

“…22 It is important, therefore, to make an exploratory incision before circumcising the flap to assess the adequacy and accurately locate the vessels for the proposed flap. 5,23 The IMAP flap is a valuable option when used as a pedicled island flap. As a free flap, however, it loses its advantages, and other fasciocutaneous flaps may be preferred because of their longer vascular pedicles and larger areas of skin provided.…”

Section: Discussionmentioning

confidence: 99%