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Perforator-plus flaps: a new concept in traditional flap design
1Reconstructive Surgery Centre, Command Hospital (Western Command), Chandimandir, Haryana, India. smehrotra@sify.com
Plastic and Reconstructive Surgery
|January 19, 2007
Summary
The novel perforator-plus flap technique enhances reconstructive surgery by providing a dual blood supply, improving flap survival and versatility in lower limb reconstruction. This method overcomes limitations of conventional flaps, reducing venous compromise risks.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Conventional fasciocutaneous flaps have limitations in reconstructive surgery, particularly for lower extremities, due to random blood supply and restricted mobility.
- Islanded fasciocutaneous flaps offer improved blood supply and movement but are prone to venous compromise.
Purpose of the Study:
- To introduce and evaluate the efficacy of the perforator-plus flap technique in overcoming the limitations of conventional and islanded fasciocutaneous flaps.
Main Methods:
- A novel approach involving the inclusion and retention of perforators within conventional fasciocutaneous flaps was developed.
- This technique was applied to 12 cases, creating a dual blood supply from both the dissected perforator and the flap base.
- Peninsular flaps were designed to incorporate dissected perforators for enhanced mobility.
Main Results:
- All perforator-plus flaps demonstrated complete survival without venous compromise.
- The technique was successfully applied in 10 out of 12 cases, with two converted to pure islanded flaps due to mobility constraints.
- Minor complications included wound infections in two patients, which resolved with conservative treatment; no reoperations were required.
Conclusions:
- The perforator-plus flap is a versatile and reliable reconstructive option for lower limb injuries and other diverse surgical indications.
- This technique offers a valuable alternative in both emergency and elective reconstructive procedures.
