Pedicled-perforator (propeller) flaps in lower extremity defects: a systematic review

Area of Science:

• Plastic Surgery
• Orthopedic Surgery
• Microsurgery

Background:

• Pedicled-perforator (propeller) flaps offer advantages like minimal donor site morbidity and
• like-by-like
• tissue replacement for lower extremity reconstruction.
• Their popularity is increasing due to a relatively simple surgical technique.

Purpose of the Study:

• To analyze the clinical use and reliability of pedicled-perforator flaps in lower extremity reconstruction.
• To evaluate the impact of patient demographics, defect characteristics, and flap parameters on complication rates.

Main Methods:

• A systematic review of PubMed was conducted using terms related to perforator, pedicled, and propeller flaps in the lower extremity.
• Data from 15 case series, encompassing 186 cases, were analyzed using Chi-square tests.

Main Results:

• Peroneal Artery Perforator (PAP) and Posterior Tibial Artery Perforator (PTAP) flaps were most commonly used.
• The overall complication rate was 25.8%, with a 1.1% failure rate.
• No significant differences in complications were observed based on age, gender, etiology, defect location, flap type, or size.

Conclusions:

• Pedicled-perforator flaps demonstrate reliability and safety for soft tissue defect coverage in the lower extremity.
• Partial flap loss and venous congestion were the most frequent complications, occurring at 11.3% and 8.1%, respectively.