Propeller flap reconstruction of abdominal defects: Review of the literature and case report

Abstract

The abdominal wall is perfused anteriorly by the superior and deep epigastric vessels with a smaller contribution from the superficial system. The lateral abdominal wall is perfused predominantly from perforators arising from the intercostal vessels. Reconstruction of soft tissue defects involving the abdomen presents a difficult challenge for reconstructive surgeons. Pedicle perforator propeller flaps can be used to reconstruct defects of the abdomen, and here we present a thorough review of the literature as well as a case illustrating the perforasome propeller flap concept. A patient underwent resection for dermatofibrosarcoma protuberans resulting in a large defect of the epigastric soft tissue. A propeller flap was designed based on a perforator arising from the superior deep epigastric vessels and was rotated 90° into the defect allowing primary closure of the donor site. The patient healed uneventfully and was without recurrent disease 37 months following reconstruction. Perforator propeller flaps can be used successfully in reconstruction of abdominal defects and should be incorporated into the armamentarium of reconstructive microsurgeons already facile with perforator dissections.

Total aesthetic subunit reconstruction of the burned anterior abdomen using pre‐expanded pedicled anterolateral thigh flap—A case report

“…Reconstructions become even more difficult, especially if superior aesthetic outcomes are desired in addition to the functionality. Locoregional perforator flaps are among the preferred methods in such circumstances (Sacks et al, ; Scaglioni, Giuseppe, & Chang, ). Combination of tissue expansion and perforator flaps broadened the reconstructive options in difficult burn cases, where wide and highly contracted scars need to be replaced with equally wide but thinner tissues (Acarturk, ; Acarturk, Glaser, & Newton, ; Hallock, ; Hocaoglu, ; Tsai, ; Wang et al, ).…”

A simple concept for covering pressure sores: wound edge‐based propeller perforator flap

“…Although they were initially described for pressure sore reconstruction and mainly suggested for extremity reconstruction, they can also be used in various locations. With regards to pressure sores, these flaps have the advantage of being reliable, reducing the operative time and being easy to perform, along with reducing donor site morbidity. …”

“…Although they were initially described for pressure sore reconstruction and mainly suggested for extremity reconstruction, they can also be used in various locations. (18) With regards to pressure sores, these flaps have the advantage of being reliable, reducing the operative time and being easy to perform, along with reducing donor site morbidity. (5,(19)(20)(21) In this study, we used the propeller perforator flap model based on newly formed or enlarged perforators located in the chronic wound edge, rather than those based on anatomically well-defined source vessels.…”

Coverage of supraumbilical abdominal wall defects: The tunnelled‐pedicled ALT technique

“…Although reconstruction is typically performed in pedicled fashion, the use of free flaps such as latissimus dorsi muscle, tensor fasciae lata, or ALT flaps is a reliable option, considered with increasing frequency a first choice by many experienced surgeons. Propeller design pedicled flap is another alternative, which has been used for coverage of soft tissue defects in abdominal region . However, the propeller flaps may not be suitable for large abdominal defects since they use the abdominal tissue itself for reconstruction.…”