Propeller Flaps in the Upper Extremity: Arm and Forearm Reconstruction.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Anatomy

Background:

• Soft tissue defects in the upper arm and forearm present reconstructive challenges.
• Traditional methods may involve significant donor site morbidity or complex microvascular procedures.
• Propeller flaps offer an alternative by utilizing local tissue with preserved vascular supply.

Purpose of the Study:

• To evaluate the efficacy and aesthetic outcomes of propeller flaps for soft tissue defects in the upper extremity.
• To describe the surgical technique, emphasizing anatomical considerations for propeller flap design.
• To present a case series of successful reconstructions using propeller flaps.

Main Methods:

• A retrospective review of 27 cases undergoing propeller flap reconstruction for upper arm and forearm defects.
• Detailed description of the surgical technique, including perforator selection and flap design.
• Emphasis on a freestyle approach for customizing perforator-based propeller flaps.

Main Results:

• Successful reconstruction of 27 soft tissue defects in the upper arm and forearm.
• Propeller flaps provided reliable tissue coverage with good aesthetic results.
• The technique spared major upper extremity vessels and minimized donor site morbidity.

Conclusions:

• Perforator-based propeller flaps are a reliable and aesthetically favorable option for upper extremity soft tissue reconstruction.
• This technique offers advantages including local tissue transfer, preservation of major vessels, and reduced operating time and cost.
• The freestyle approach allows for customization to various defect sizes.