“…1 ), 343 studies qualified for the second stage of selection, and, after the screening of 117 full-text papers, 41 studies met the definitive inclusion criteria. Of the selected 41 articles, 25 were case series, original papers or retrospective reviews [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 ] and were included, whereas 15 were case report papers and therefore were excluded. Among the reports that were included, two hundred eighty-eight propeller flaps have been reported to have been used in a total of 276 patients.…”
Section: Resultsmentioning
confidence: 99%
“…Ninety-one upper limb patients were treated with 99 propeller flaps [ 2 3 7 20 21 22 23 24 25 ] for hand, axilla and elbow post-burn contracture [ 20 21 22 23 25 ] as well as trauma and post-trauma sequelae [ 2 6 7 23 24 25 ], tumor excision [ 2 3 25 ], closure of the surgical donor site [ 3 ], bursitis [ 23 ] and radiodermitis [ 23 ]. Eight patients received double flap reconstructions [ 20 ].…”
Section: Resultsmentioning
confidence: 99%
“…Eight patients received double flap reconstructions [ 20 ]. Many (n=45) of the propeller flaps used the radial artery perforators [ 2 3 6 23 25 ] as the axes, and 39 [ 20 21 22 ] were nourished by a subcutaneous random pedicle, using the "central axis flap methods" originally described by Hyakasoku et al [ 5 ]. The source vessels used for the remaining flaps were equally distributed among vessels of the upper limb [ 2 3 7 22 25 ].…”
Section: Resultsmentioning
confidence: 99%
“…In the other 42 cases, these data were not available [3,6,20,25]. A flap suffering from venous congestion was not re-explored because the congestion resolved spontaneously [22]. Necrosis of the distal 40% of the flap (superior ulnar collateral artery perforator flap) in one patient due to flow congestion after primary closure of a flap defect in the arm required debridement and skin grafting.…”
BackgroundThe aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects.MethodsA comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis.ResultsFrom the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed.ConclusionsPedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.
“…1 ), 343 studies qualified for the second stage of selection, and, after the screening of 117 full-text papers, 41 studies met the definitive inclusion criteria. Of the selected 41 articles, 25 were case series, original papers or retrospective reviews [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 ] and were included, whereas 15 were case report papers and therefore were excluded. Among the reports that were included, two hundred eighty-eight propeller flaps have been reported to have been used in a total of 276 patients.…”
Section: Resultsmentioning
confidence: 99%
“…Ninety-one upper limb patients were treated with 99 propeller flaps [ 2 3 7 20 21 22 23 24 25 ] for hand, axilla and elbow post-burn contracture [ 20 21 22 23 25 ] as well as trauma and post-trauma sequelae [ 2 6 7 23 24 25 ], tumor excision [ 2 3 25 ], closure of the surgical donor site [ 3 ], bursitis [ 23 ] and radiodermitis [ 23 ]. Eight patients received double flap reconstructions [ 20 ].…”
Section: Resultsmentioning
confidence: 99%
“…Eight patients received double flap reconstructions [ 20 ]. Many (n=45) of the propeller flaps used the radial artery perforators [ 2 3 6 23 25 ] as the axes, and 39 [ 20 21 22 ] were nourished by a subcutaneous random pedicle, using the "central axis flap methods" originally described by Hyakasoku et al [ 5 ]. The source vessels used for the remaining flaps were equally distributed among vessels of the upper limb [ 2 3 7 22 25 ].…”
Section: Resultsmentioning
confidence: 99%
“…In the other 42 cases, these data were not available [3,6,20,25]. A flap suffering from venous congestion was not re-explored because the congestion resolved spontaneously [22]. Necrosis of the distal 40% of the flap (superior ulnar collateral artery perforator flap) in one patient due to flow congestion after primary closure of a flap defect in the arm required debridement and skin grafting.…”
BackgroundThe aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects.MethodsA comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis.ResultsFrom the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed.ConclusionsPedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.
“…It is not necessary to rotate all the triangular flaps in the same direction. In some cases, it may also be possible to partly close primarily the V-shaped donor [23]. Fig.…”
Contractures of the axilla and elbow can produce a significant impact on quality of life by reducing the ability to perform activities of daily living. Varieties of techniques are available for resurfacing defects following contracture release but graft or flap loss, donor-site morbidity, esthetics, and recurrences are still challenges for reconstructive surgeons. Central axis “propeller” flaps based on a random, subcutaneous pedicle were first described for axillary and elbow contractures to deploy the unburnt skin of axillary dome in type I and II contractures (Kurtzman and Stern) by moving them 90° to straddle the contracting bands. This strategy provided better esthetics and avoided prolonged splinting. Over more than two decades, there have been several design modifications of these flaps with extended applications to cubital fossa. A comprehensive review of published literature on the topic is presented to discuss classifications, design modifications, and applications of such flaps in managing axillary and elbow contractures.
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