Propeller Flaps: A Review of Indications, Technique, and Results

D’Arpa, Salvatore; Toia, Francesca; Pirrello, Roberto; Moschella, Francesco; Cordova, Adriana

doi:10.1155/2014/986829

Cited by 45 publications

(54 citation statements)

References 40 publications

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“…However, it is likely more common that what is generally perceived or at least it is given less relevance. Most authors attribute the cause of failure to a pedicle torsion that causes vessel (arteries) occlusion 7,9,40 : this can be true indeed, but we have also observed that arterial insufficiency can be most common than what is generally believed, not only because the perfusion pressure of the perforator is insufficient but also, as mentioned previously, because the flap is located away from its vascular territory. In cases of arterial insufficiency, the flap (or part of it) becomes pale and cool due to reduced arterial inflow, with slow or absent capillary refill.…”

Section: Arterial Insufficiencysupporting

confidence: 78%

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Complications and Solutions in Propeller Flap Surgery

et al. 2020

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Propeller perforator flaps (PPFs) have long been proven as valid reconstructive tools for a wide range of soft tissue defects in different body regions. During the last decade, despite their numerous advantages, many authors have thoroughly analyzed outcomes of these flaps, sometimes discouraging their use mainly because of a high failure rate. Accurate patient selection, adequate preoperative planning, and an appropriate dissection technique seem to potentially improve outcomes. Our study provides a review of the relevant literature related to PPF complications and of our experience, describing reasons for failure, measures for preventing them, and approaches for a prompt evaluation and management of complications.

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Section: Arterial Insufficiencysupporting

confidence: 78%

“…But instead they survive, despite extreme arcs of rotation (180 degrees) and length/ width ratios (4/1 to 6/1). 7,19 The size of the flap or the degree of rotation may not be the only explanation for propeller flap failure. An extremely large perforator despite high flow and robustness may fail to nourish a flap that is located away from its perforasome.…”

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confidence: 99%

Complications and Solutions in Propeller Flap Surgery

et al. 2020

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“…On the other hand, propeller flaps proved to be a very useful addition to the reconstructive toolbox and gained increasing diffusion in recent years. 17,31,32 The propeller concept increased the number of potential donor sites particularly in those anatomical districts, such as the Achilles region, where conventional pedicled flaps are not feasible because they do not have enough arch of rotation. Propeller flaps allow for reconstruction "like with like" and present a very low morbidity at the donor site; in addition, they are relatively fast procedures and can be done in peripheral anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Achilles Region Soft-Tissue Defects: A Reconstructive Algorithm Based on a Series of 46 Cases

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Ghezzi

et al. 2017

J reconstr Microsurg

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Background Several options have been described for soft-tissue reconstruction in Achilles tendon region (ATR). The best procedure should be customized according to any single case taking into account the number of structures involved, the quality of the neighboring skin, and patient's general condition. The aim of this article is to describe a simplified reconstructive algorithm based on personal experience and reviewing literature. Methods Forty-four patients, who underwent ATR soft-tissue reconstruction between 1998 and 2016, have been retrospectively reviewed. Etiologies of the defect include the following: 18 posttraumatic, 10 postoncologic, 14 dehiscence/infection, and 2 chronic ulcers. Follow-up ranges between 12 and 96 months. Free flaps have been used in 30 cases (including two secondary surgeries due to propeller flap failure) and propeller flaps have been used in 16 cases. Results Thirty-six flaps survived uneventfully (78.3%). Total flap necrosis occurred in three cases (6.5%), namely, two propeller flaps and one free flap. Partial necrosis of the flap was observed in seven cases (15, 2%): three in the free flap group and four in the propeller group. The functional recovery was very good in all the patients without involvement of the tendon and also all the patients who underwent a simultaneous reconstruction of the tendon with different techniques recovered a full weight bearing and a satisfactory range of motion. Conclusion Propeller flaps are a valuable option for skin reconstruction in case of defects of small and medium size not involving the tendon. In case of larger defects and when a simultaneous ATR reconstruction is required, a free flap seems to be a better option.

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“…The pliability of the soft tissue around the DLAAP flap pedicle contributes to the increased flap mobility. [19][20][21] Doubtless, the rich mucosal vascularization and the laxity of the soft tissue surrounding the pedicle increase the survival rate of these flaps. The typical villous appearance of the tongue tissue disappears once the flap is transferred to the recipient site, becoming as smooth as the surrounding mucosa within 1 month after surgery.…”

Section: Deep Lingual Artery Axial Propeller Flapmentioning

confidence: 99%

Propeller Flaps in the Head and Neck

et al. 2020

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Propeller flaps have significantly expanded the reconstruction possibilities in the head and neck region. They allow for increased flap mobility and better scar concealing, and/or to perform a one-stage reconstruction with local tissue of similar color and texture, where multiple surgeries would be needed with traditional flaps or even free flaps would be required. This article describes the main propeller flaps for one-stage reconstruction in the head–neck region (facial artery perforator, supratrochlear artery axial perforator, deep lingual artery axial perforator, and anterior supraclavicular artery perforator flaps), their indications, and possible complications. Aesthetic and functional results of propeller flaps in the head and neck region are very good and the complication rate is low, but due to their surgical complexity and the availability of many simpler local flaps, they are indicated only in select cases where local flaps are unavailable or would require multiple staged procedures to complete the construction.

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Propeller Flaps: A Review of Indications, Technique, and Results

Cited by 45 publications

References 40 publications

Complications and Solutions in Propeller Flap Surgery

Complications and Solutions in Propeller Flap Surgery

Achilles Region Soft-Tissue Defects: A Reconstructive Algorithm Based on a Series of 46 Cases

Propeller Flaps in the Head and Neck

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