Perforator-Based Propeller Flap with Additional Venous Pedicle for Lower Limb Reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Vascular Surgery

Background:

• Propeller flaps are valuable for lower limb defects, offering an alternative to free flaps.
• Perforator-based propeller flaps can experience venous congestion due to kinking during rotation.
• Maintaining major vessel integrity and addressing donor/recipient sites in one field are advantages.

Purpose of the Study:

• To modify propeller flaps for improved venous drainage in lower limb reconstruction.
• To prevent flap congestion and necrosis in reconstructive surgery.
• To assess the efficacy of incorporating superficial veins into propeller flaps.

Main Methods:

• Modification of propeller flaps by including the great saphenous or short saphenous vein.
• Raising flaps based on a single perforator from a major lower limb vessel.
• Utilizing handheld and color Doppler to confirm venous patency postoperatively.

Main Results:

• No instances of flap congestion or necrosis were observed postoperatively.
• The incorporated superficial vein provided enhanced retrograde or antegrade venous drainage.
• Confirmed patency of the incorporated vein using Doppler ultrasound.

Conclusions:

• Incorporating superficial veins into propeller flaps is a safe and effective modification for lower limb reconstruction.
• This technique successfully mitigates the risk of venous congestion and flap necrosis.
• The modified propeller flap offers a reliable solution for small-to-medium sized lower limb defects.