Reconstruction of extensive upper extremity defects using pre-expanded oblique perforator-based paraumbilical flaps

Zang, Mengqing; Zhu, Shan; Song, Bin; Ji, Jin; Liu, Donghong; Ding, Qiang; Liu, Yuanbo

doi:10.1016/j.burns.2012.01.002

Cited by 21 publications

(12 citation statements)

References 17 publications

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“…Moreover, locating the expander under the fascia lata necessitates additional scoring of the fascia and also partial fasciectomy for obtaining enough extensibility of the tissue and harvesting this tissue leads to fascial defects . Previously, only few suprafascially pre‐expanded flap procedures have been demonstrated and most of them are “local perforator based flap” techniques which does not include intramuscular perforator vessel dissection . Considering those, 10 of our flaps were harvested as and represent true perforator flaps that have been transferred either locally or freely.…”

Section: Discussionmentioning

confidence: 99%

“…It has many advantages over computerized tomography angiography (CTA) which is otherwise accepted as the gold standard for perforator imaging by many authors . For instance, CDU is noninvasive, cause no radiation exposure and is low cost . It is a fact that CDU is a physician dependent device but smaller perforators could also be missed by CT angiography depending on the machine's pixel resolution .…”

Section: Discussionmentioning

confidence: 99%

“…18 Previously, only few suprafascially preexpanded flap procedures have been demonstrated and most of them are "local perforator based flap" techniques which does not include intramuscular perforator vessel dissection. 8,19 Considering those, 10 of our flaps were harvested as and represent true perforator flaps that have been transferred either locally or freely.…”

Section: Discussionmentioning

confidence: 99%

“…20,21 For instance, CDU is noninvasive, cause no radiation exposure and is low cost. 19 It is a fact that CDU is a physician dependent device but smaller perforators could also be missed by CT angiography depending on the machine's pixel resolution. 8 In pre-operative perforator mapping, HHD can only be considered as an adjunct, especially if the case is a pre-expanded perforator flap procedure.…”

Section: Discussionmentioning

confidence: 99%

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Suprafascial pre‐expansion of perforator flaps and the effect of pre‐expansion on perforator artery diameter

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Suprafascial pre‐expansion of perforator flaps and the effect of pre‐expansion on perforator artery diameter

et al. 2013

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“…Most of the abdominal pedicle flaps were the random flaps so that their application was restricted by flap's length/width ratio and the transfer angle [1]. In 1983, Taylor and others first reported the use of the paraumbilical perforator flap [2], which is a type of axial vascular flap supplied by the perforator vessels beside the umbilicus.…”

Section: Introductionmentioning

confidence: 99%

Paraumbilical Perforator Flap: A Good Choice for the Repair of the Deep Soft Tissue Defects in the Hand and Forearm

Wang¹,

Min²,

Xu³

et al. 2017

J Gen Pract

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Objective: Severe trauma to the hand or forearm often results in the deep soft tissue defect with the exposure of tendon or bone, which needs to be repaired by skin flaps. In this study, we introduced the use of paraumbilical perforator flap in the repair of such defects, and discussed its advantages and disadvantages.Methods: From Jan. 2006 to Dec. 2016, 14 patients with deep soft tissue defects in the hand and forearm were admitted into our clinic. The defects were caused by hot-crush injury (n=2), electrical injury (n=4), severe burn (n=2), crush injury (n=3), and avulsion injury (n=3). After admission, the patients underwent the debridement, vacuum suction, and skin graft to repair partial wound. The deep defects with the exposure of tendon and bone were repaired by paraumbilical perforator flap finally.Results: All of the 14 flaps survived after the transfer in the first-stage operation. The width of the flap's pedicle ranged from 6 cm to 8 cm, and the length ranged from 16 cm to 20 cm. 1620 days later, the second-stage operation was done to divide the pedicle. After the division, 11/14 of the flaps survived well. The remaining 3/14 flaps had the partial necrosis of the margin, which healed with changing dressing. In the follow-up period, most of the flaps had satisfying appearance. 2 flaps were bulky and thinned by surgery. Conclusions:The paraumbilical perforator flap has reliable blood supply, good texture, sufficient area, and is convenient to transfer. It's an ideal choice for the repair of the deep soft tissue defect in the hand and forearm.

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Freestyle perforator‐based propeller flap of medial arm for medial elbow reconstruction

Zang

et al. 2014

Microsurgery

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Elbow reconstruction is challenging for reconstructive surgeons. The purpose of this report is to present the results of the use of freestyle perforator-based propeller flap designed from the medial arm region for elbow reconstruction. The defects following soft tissue sarcoma resection at the medial and posterior elbow were repaired in two patients. The dimensions of the defects were 11 × 7 cm(2) and 10 × 7 cm(2). Two perforators were identified in each case using Doppler ultrasound probe in the medial arm, adjacent to the defect. The perforator with visible pulsation was chosen as the pedicle vessel, which was 12-cm and 7-cm proximal to the medial epicondyle. An elliptical flap, extending almost the full length of arm, was raised and rotated 180° to repair medial elbow defects. The sizes of the flaps were 17 × 8 cm(2) and 11 × 7 cm(2). The donor sites were closed directly. Both flaps survived; temporary venous congestion occurred in one case. There were no other postoperative complications. These cases illustrated that the medial arm flap might be used for reconstruction of medial elbow defects with this freestyle perforator-based propeller flap design.

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Reconstruction of extensive upper extremity defects using pre-expanded oblique perforator-based paraumbilical flaps

Cited by 21 publications

References 17 publications

Suprafascial pre‐expansion of perforator flaps and the effect of pre‐expansion on perforator artery diameter

Suprafascial pre‐expansion of perforator flaps and the effect of pre‐expansion on perforator artery diameter

Paraumbilical Perforator Flap: A Good Choice for the Repair of the Deep Soft Tissue Defects in the Hand and Forearm

Freestyle perforator‐based propeller flap of medial arm for medial elbow reconstruction

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