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Perforator-Based Propeller Flap Application in Pressure Ulcer Reconstruction: A Comparative Analysis With Advancement
Jong-Ho Kim1, Man Wong Han1, Joseph Kyu-Hyung Park1
1Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
Microsurgery
|January 21, 2025
Summary
Perforator-based propeller flaps (PBPF) offer a lower recurrence rate for pressure ulcers compared to advancement flaps (AF), despite longer operation times. This makes PBPF a valuable surgical option for reducing pressure ulcer recurrence.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Wound Healing
Background:
- Pressure ulcers are a significant clinical challenge requiring surgical reconstruction.
- Advancement flaps (AF) and Perforator-based Propeller Flaps (PBPF) are common reconstructive techniques.
- Limited comparative data exists for these techniques in pressure ulcer management.
Purpose of the Study:
- To compare the outcomes of PBPF versus AF in pressure ulcer reconstruction.
- To evaluate the efficacy and complication rates of each surgical technique.
- To identify the optimal reconstructive approach for pressure ulcers.
Main Methods:
- Retrospective analysis of 56 patients undergoing pressure ulcer reconstruction.
- Comparison of AF and PBPF techniques from January 2020 to December 2023.
- Data collected included demographics, ulcer details, operative time, hospital stay, recurrence, and complications.
Main Results:
- No significant differences in defect size, hospitalization, follow-up duration, preoperative debridements, time to recurrence, or postoperative complications.
- PBPF utilized smaller flap sizes (70.5 cm² vs. 93.7 cm² for AF).
- PBPF had longer operation times (161.0 min vs. 94.6 min for AF) but a significantly lower long-term recurrence rate (p=0.036).
Conclusions:
- PBPF is associated with longer surgical times due to its complexity.
- PBPF demonstrates a reduced recurrence rate for pressure ulcers when applied appropriately.
- PBPF represents a meaningful surgical approach for improving long-term outcomes in pressure ulcer reconstruction.
