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Propeller Perforator Flaps Used for Hand and Digit Reconstruction: A Systematic Review

  • 0Georgetown University School of Medicine, Washington, Dist. of Columbia, United States.
Journal of Hand and Microsurgery +

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June 10, 2024

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June 10, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Propeller perforator flaps (PPFs) offer a reliable method for hand reconstruction, effectively covering defects with a high survival rate. Complications are generally minor and resolve without further intervention, making PPFs a valuable surgical option.

Area Of Science

  • Plastic Surgery
  • Microsurgery
  • Reconstructive Surgery

Background

  • Propeller perforator flaps (PPFs) are increasingly utilized for their design flexibility and ability to reconstruct defects without compromising major vessels.
  • Existing literature lacks specific guidance on using PPFs for intricate hand reconstructions.
  • This study addresses the need for a comprehensive review of PPF techniques in hand reconstruction.

Purpose Of The Study

  • To systematically review and evaluate the current literature on the application of propeller perforator flaps (PPFs) for hand reconstruction.
  • To assess the efficacy and safety of various PPF techniques in repairing hand and digital defects.
  • To provide guidance for surgeons considering PPFs in upper limb reconstruction.

Main Methods

  • A systematic literature review was conducted following PRISMA guidelines, searching databases for studies from 1991 to 2021.
  • Included studies focused on propeller perforator flaps (PPFs) for hand and digit defects, excluding other upper extremity or lower extremity reconstructions.
  • Data extracted included study characteristics, patient demographics, flap types, survival rates, and complications.

Main Results

  • The review included 25 studies involving 525 patients and 613 propeller perforator flaps (PPFs) for hand/digit reconstruction.
  • Overall flap survival was high at 97.8%, with acute wounds being the most common indication (72.9%).
  • Complications occurred in 19.8% of cases, but most resolved without secondary procedures, yielding a low flap failure rate of 2.1%.

Conclusions

  • Propeller perforator flaps (PPFs) demonstrate reliability and effectiveness for reconstructing defects in the hand and digits.
  • These flaps allow defect coverage without sacrificing essential local vasculature, preserving function.
  • Despite a notable complication rate, the majority of issues are manageable, supporting PPFs as a viable reconstructive option.

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