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Perforator plus flaps: Optimizing results while preserving function and esthesis.

Sandeep Mehrotra1

  • 1Sr Adv (Surgery& Plastic), Command Hospital (Central Command), Lucknow 226 002.

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India
|January 11, 2011
PubMed
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The perforator plus flap technique offers robust wound cover with dual vascular supply, preserving function and aesthetics. This innovative approach minimizes collateral damage, providing a superior alternative to traditional reconstructive methods.

Area of Science:

  • Reconstructive Surgery
  • Plastic Surgery
  • Microsurgery

Background:

  • Traditional flaps often result in collateral damage to functional muscle, vessels, or nerves.
  • The perforator plus flap concept utilizes dual vascular supply to enhance flap viability.
  • This technique aims to preserve nerves, vessels, and muscle function, improving outcomes.

Purpose of the Study:

  • To evaluate the application and outcomes of the perforator plus flap technique in diverse clinical scenarios.
  • To assess the efficacy of perforator plus flaps in providing stable wound cover while minimizing functional and aesthetic deficits.

Main Methods:

  • The perforator plus concept was applied to seven patients with various defects, including lower extremity and back injuries.
  • Functional muscle, fasciocutaneous, and adipofascial flaps were utilized.
Keywords:
Function and form preservationperforator plus flaps

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  • Specific cases included coverage for tibial fractures and chronic venous ulcers.

    • Main Results:

    • All perforator plus flaps achieved successful survival and provided long-term stable coverage over soft tissue and bone.
    • Functional preservation was noted in all muscle flap cases, with no loss of power.
    • Neurovascular preservation resulted in no sensory loss or significant edema; fracture union was satisfactory.

    Conclusions:

    • The perforator plus concept is a versatile and holistic approach applicable to various flap types and clinical situations.
    • This technique effectively limits collateral functional damage and addresses aesthetic considerations, particularly with adipofascial flaps.
    • Perforator plus flaps represent a superior alternative to traditional flaps and free tissue transfers due to quick operating times and low failure rates.