Pedicled perforator‐based flaps: Risk factor analysis, outcomes evaluation and decisional algorithm based on 130 consecutive reconstructions

Abstract

IntroductionPedicled perforator flaps are widely used for soft tissue reconstruction, but evidence in literature about risk factors associated with complications is still controvert. The aim of this study is to evaluate risk factors and outcomes associated with pedicled perforator‐based flaps harvested at different anatomical sites.Patients and methodsSeventy‐one propeller and 59 V‐Y advancement flaps were performed to reconstruct defects of the face (24 cases), trunk (47 cases), and extremities (59 cases). Mean defect and flap area were 32.43 and 43.2 cm2, respectively. The average age recorded was 66 years. We statistically analyzed whether patient and flap‐related variables had an impact on flap vascular complications rate. Patients were asked to rate on a 5‐point Likert scale the aesthetic and functional outcomes of the surgery.ResultsOverall flap complications rate was 23.07%. Coronary heart disease was an independent risk factor for flap complications (p = .010), while hypertension was associated with a lower complication rate (p = .010). The increasing degree of pedicle rotation had a significant impact on the development of flap vascular complications (p = .008). Mean patients' aesthetic and functional ratings were 4.23 of 5 and 4.37 of 5, respectively.ConclusionsWe found a positive correlation between both coronary heart disease and increasing degree of pedicle rotation and complications. Other factors tested were not significantly associated with complications. Patients were overall satisfied with both the aesthetic and functional outcomes of the procedure. The decisional algorithm hereby suggested yields a 93.1% overall success rate and we believe it could be of help to plastic surgeons approaching soft tissue defects.

Versatility of the lateral circumflex femoral artery sparing perforator‐based anterolateral thigh flaps in loco‐regional thigh reconstruction after skin cancer, melanoma, and sarcoma resection

“…Cutaneous perforators (Yu & Youssef, 2006) were identified with the aid of Doppler and angio‐CT/MRI, when performed preoperatively for oncological purposes. According to our previously published experience, (Brunetti et al, 2020) the best flap design (Brunetti et al, 2013; Brunetti et al, 2017) (Figures 1, 2) was chosen in a free style fashion, favoring propeller flaps for proximal and distal locations. The surgical technique was similar to other published papers on this topic (Brunetti et al, 2020).…”

Factores pronósticos asociados a fracaso de colgajos

“…En nuestra serie, la indicación más común para la realización de un colgajo fue la malignidad y la localización más común fue la cara, esto concuerda con la bibliografía consultada. 13,15 Sólo en 23.4% de los pacientes se cumplieron de manera completa las indicaciones de los centros para el control y la prevención de enfermedades. 16 A pesar de esto, este factor no tuvo asociación con complicaciones ni fracaso de los colgajos; sin embargo, estas cifras son alarmantes.…”

Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi ile Onarılması

“…180 derecelik rotasyon arkına sahip olan bu flepler serbest flep alternatifidir. Bu fleplerin öğrenme eğrisi uzundur ve teknik ekipman gereksinimi vardır [8]. Propellar flepleri, yeterli hacim ve obliterasyon kapasitesine sahip olmamaları nedeniyle zeminde osteomyelit olan vakalarda tercih etmiyoruz.…”