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Pedicled perforator flaps in the head and neck.
Stefan O P Hofer1, Marc A M Mureau
1Division of Plastic Surgery, Department of Surgery, University Health Network, 200 Elizabeth Street, 8N-865 Toronto, ON, Canada. stefan.hofer@uhn.on.ca
Clinics in Plastic Surgery
|September 7, 2010
Summary
Perforator flaps have transformed reconstructive surgery, becoming a preferred option for many procedures. However, surgeons must critically assess defects to ensure perforator flaps are the optimal choice over traditional methods.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Perforator flaps, introduced in 1989, have significantly advanced reconstructive surgery techniques.
- Initially met with skepticism, perforator flaps are now frequently the primary choice for many surgical reconstructions.
- Despite their success, the application of perforator flaps requires careful consideration.
Purpose of the Study:
- To evaluate the current role and indications of perforator flaps in reconstructive surgery.
- To emphasize the importance of critical assessment in selecting appropriate reconstructive methods.
- To highlight the continued relevance of non-perforator flaps in specific clinical scenarios.
Main Methods:
- Review of the evolution and application of perforator flaps in reconstructive surgery.
- Analysis of the decision-making process for selecting flaps based on defect characteristics.
- Comparison of outcomes between perforator and non-perforator flap reconstructions.
Main Results:
- Perforator flaps have become a highly reliable and often preferred option in reconstructive surgery.
- Non-perforator flaps remain valuable and can yield excellent results for certain indications.
- The critical skill lies in defect assessment and strategic flap selection, not solely flap harvesting.
Conclusions:
- While perforator flaps are revolutionary, they are not universally required for all reconstructions.
- Surgeons must judiciously choose between perforator and non-perforator flaps based on individual patient needs and defect complexity.
- Expertise in defect assessment and reconstructive planning is paramount for successful outcomes in head and neck surgery.
