Perforator-based propeller flaps for leg reconstruction in pediatric patients

Area of Science:

• Plastic Surgery
• Pediatric Orthopedics
• Reconstructive Surgery

Background:

• Perforator-based propeller flaps are utilized for soft tissue coverage in leg reconstruction.
• Assessing the versatility and reliability of these flaps in pediatric patients is crucial.

Purpose of the Study:

• To evaluate the efficacy of perforator-based propeller flaps for lower extremity reconstruction in pediatric patients.
• To determine the safety and versatility of this reconstructive method in a young population.

Main Methods:

• A cohort of seven male pediatric patients (ages 2-13) underwent perforator-based propeller flap surgery.
• Defects were caused by burn injuries or traffic accidents, located on the ankle, knee, tibia, or foot.
• Flaps were based on the posterior tibial, anterior tibial, or lateral circumflex femoral arteries.

Main Results:

• Flap sizes averaged 7.6 × 4.3 cm, with harvesting times around 46 minutes.
• Flap rotations ranged from 90° to 180°.
• All flaps survived, though one patient experienced a fatal complication (disseminated intravascular coagulation).

Conclusions:

• Perforator-based propeller flap reconstruction is a safe, reliable, and versatile option for pediatric lower extremity reconstruction.
• Meticulous surgical dissection and patience are essential for successful outcomes.
• The technique demonstrates significant potential despite a rare severe complication.