Perforator-Plus Flaps: A New Concept in Traditional Flap Design

Abstract

The perforator-plus flap appears to be a versatile and reliable option in lower limb injuries and other diverse indications, in both the emergency and the elective settings.

The hand held Doppler device for the detection of perforators in reconstructive surgery: What you hear is not always what you get

“…The use of perforator-based flaps in reconstructive (burn) surgery has increased significantly and has been established as a safe procedure [1][2][3][4][5][6]. Because perforators are distributed throughout the body, viable flaps can be raised from a great variety of anatomical locations [7].…”

Distally based reverse sural artery flap as an interpolation flap

“…10 Reverse sural artery flap was regarded as a type A fasciocutaneous flap by Morgan et al, but the flap in this study should belong to a type B fasciocutaneous flap according to the classification introduced by Cormack and Lamberty, because there is a single sizeable fasciocutaneous perforator of peroneal artery contained at the base of the flap. 11,12 The flaps harvested in this study are similar to perforator-plus fasciocutaneous flap described by Mehrotra and peninsular pedicled peroneal arterial perforator flap described by Lu et al 13,14 The flaps have characteristics of both perforator flaps and fasciocutaneous flaps in which length -width ratio plays an important role in viability of the flaps. These flaps obtain dominant blood supply from the perforators of the peroneal vessels; Width of the base of flap is associated with arterial supply and venous drainage.…”

Anatomic basis and clinical application of the distally based medialis pedis flaps

“…What is more, the adipofascial tissue retained in the pedicle is helpful to vein drainage and its subcutaneous plexus oriented along the neurovascular bundles may improve the axiality of the supply and contribute to length [34]; therefore, it depends on a surgeon' s personal preference which surgical procedure to choose by weighing their respective advantages and disadvantages [43].…”