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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
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705
Free versus Pedicled Perforator Flaps for Lower Extremity Reconstruction: A Multicenter Comparison of Institutional
Keith Koh1, Terence L H Goh1, Christopher Tam Song1
1Plastic Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore.
Journal of Reconstructive Microsurgery
|April 17, 2018
Summary
Perforator flaps, both free and pedicled, offer successful solutions for challenging lower extremity wounds. Pedicled flaps may provide a simpler, reliable option when adjacent tissues are healthy.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Wound Healing
Background:
- Lower extremity wounds present significant challenges in treatment.
- Perforator free flaps are a viable microsurgical option.
- Pedicled perforator flaps are emerging as a simpler alternative.
Purpose of the Study:
- To compare the effectiveness of all types of perforator flaps for lower extremity reconstruction.
- To evaluate flap outcomes across different healthcare institutions.
Main Methods:
- Retrospective analysis of perforator flaps (free and pedicled) for lower extremity defects from 2011-2015.
- Inclusion of 433 free perforator flaps and 52 pedicled perforator flaps.
- Data collected from university, regional, and community hospitals.
Main Results:
- Overall success rates were high for both free (90.1%) and pedicled (92.3%) perforator flaps, with no significant difference.
- Free flaps were preferred for trauma and chronic ulcers; pedicled flaps for tumor excision.
- Large defects or foot involvement favored free flaps; peripheral vascular disease was a risk factor for failure.
Conclusions:
- Perforator flaps are effective for lower extremity soft tissue defects.
- Choice between pedicled and free flaps depends on defect characteristics, location, and patient factors.
- Pedicled perforator flaps offer a promising, simpler approach for reconstruction when feasible.
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