Related Experiment Video
Updated: Dec 30, 2025
07:58
An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps
Published on: December 5, 2025
96
Freestyle Perforator Puzzle Flap for Posterior Trunk Reconstruction
Michele Maruccia1, Giuseppe Di Taranto, Fabrizio Schonauer2
1From the Department of Plastic and Reconstructive Surgery, Azienda Ospedaliera Policlinico di Bari, Bari.
Annals of Plastic Surgery
|January 28, 2020
Summary
Reconstructive surgeons can now close large posterior trunk defects using multiple freestyle perforator flaps. This technique provides tension-free closure with minimal donor site morbidity, improving outcomes for complex cases.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Reconstructing extensive posterior trunk defects presents challenges due to the need for substantial well-vascularized tissue.
- Existing methods often struggle to adequately resurface large defects, cover exposed hardware, and fill dead spaces.
Purpose of the Study:
- To evaluate the efficacy of a multiple freestyle perforator flap approach for reconstructing large posterior trunk defects.
- To determine if this technique allows for tension-free closure and minimizes donor site morbidity.
Main Methods:
- A retrospective review of 23 patients with large posterior trunk defects treated between January 2013 and December 2016.
- Utilized a freestyle perforator-based reconstruction involving designing a sequence of flaps to fit defect dimensions.
- Performed an average of 2.6 perforator flaps per patient.
Main Results:
- Successfully reconstructed defects up to 27 x 29 cm using a total of 62 perforator flaps.
- Achieved tension-free primary closure of all donor sites with uneventful healing in all patients.
- No complications were observed, even in six patients who received postoperative radiotherapy.
Conclusions:
- The multiple freestyle perforator flap approach effectively achieves tension-free closure for extensive posterior trunk defects.
- This technique provides sufficient tissue volume and reliable vascularization, making it a valuable option for complex reconstructions.
- The method offers minimal donor site morbidity, enhancing its utility in reconstructive surgery.
