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Propeller Flap for Complex Distal Leg Reconstruction: A Versatile Alternative when Reverse Sural Artery Flap is Not
Samuel A Ademola1, Afieharo I Michael1, Femi J Oladeji1
1Department of Plastic, Reconstructive and Aesthetic Surgery, University College Hospital, Ibadan, Nigeria.
Journal of Surgical Technique and Case Report
|August 12, 2016
Summary
Perforator-based propeller flaps are a viable alternative for distal leg reconstruction when reverse sural artery flaps are not possible. These flaps offer a simpler, quicker, and more cost-effective solution for soft tissue defects, even in challenging cases.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Orthopedic Trauma
Background:
- Reverse sural artery fasciocutaneous flaps are standard for distal leg soft tissue defect reconstruction.
- Perforator-based propeller flaps present an alternative when the reverse sural artery flap is contraindicated or unavailable.
Observation:
- Two male patients with Gustilo 3B gunshot injuries to the distal leg were treated.
- The planned donor area for the reverse sural artery flap was compromised in both cases.
- Early debridement, external fixation, and reconstruction with perforator-based propeller flaps were performed.
Findings:
- All perforator-based propeller flaps survived successfully.
- Donor sites were managed with skin grafts.
- Minor wound edge ulcers occurred due to positioning but healed conservatively without compromising flap viability.
Implications:
- Perforator-based propeller flaps are a versatile and effective option for distal leg soft tissue reconstruction, particularly in resource-limited settings.
- This technique is especially valuable when the preferred reverse sural artery flap donor site is injured.
- It provides a practical alternative to free flaps for complex lower extremity trauma.
