The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases
نویسندگان
چکیده
BACKGROUND Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin grafting (SG) with or without negative pressure wound therapy and local random flaps have been used with varying degrees of success to cover diabetic lower leg or foot ulcerations. Other methods include: local or regional muscle and fasciocutaneous flaps, free muscle and fasciocutaneous, or perforator flaps, which also have varying degrees of success. PATIENTS AND METHODS This article reviews 25 propeller perforator flaps (PPF) which were performed in 24 diabetic patients with acute and chronic wounds involving the foot and/or lower leg. These patients were admitted beween 2008 and 2011. Fifteen PPF were based on perforators from the peroneal artery, nine from the posterior tibial artery, and one from the anterior tibial artery. RESULTS A primary healing rate (96%) was obtained in 18 (72%) cases. Revisional surgery and SG for skin necrosis was performed in six (24%) cases with one complete loss of the flap (4%) which led to a lower extremity amputation. CONCLUSIONS The purpose of this article is to review the use of PPF as an effective method for soft tissue coverage of the diabetic lower extremity and/or foot. In well-controlled diabetic patients that present with at least one permeable artery in the affected lower leg, the use of PPF may provide an alternative option for soft tissue reconstruction of acute and chronic diabetic wounds.
منابع مشابه
The Anterior Interosseus Artery Perforator Flap: Anatomical Dissections and Clinical Study
BACKGROUND Reconstruction of upper extremity deformities continues to be a challenge to the reconstructive surgeon. Various loco regional, distant and free flaps are available for reconstruction. However, each has its own set of advantages and disadvantages. Of the commonly performed local flaps, radial artery forearm flap, and the posterior interosseus artery flap stand out prominently. Rec...
متن کاملPerforator Flaps for Reconstruction of Lower Limb Defects
BACKGROUND Reconstruction of soft tissue defects in the lower third of the leg remains challenging. Anatomical constraints limit the local options available for complex defects especially lower third of leg. Local flaps based on perforator vessels are raising interest in reconstructive surgery of the limbs. We present our experience with perforator flaps for reconstruction of soft tissue def...
متن کاملUse of Local Perforator Flaps for Post Burn Reconstruction
BACKGROUND Mainstay of post-burn reconstruction is release and split skin grafting. Pedicle flaps are cumbersome to the patient, require multiple procedures and hospitalization. Free flaps are technically demanding and facilities are not universally available. Here we evaluated the local perforator flaps for post-burn reconstruction. METHODS We have used sixteen perforator propellar flaps fo...
متن کاملLower limb perforator propeller flaps - clinical applications.
BACKGROUND A great variety of flaps have been used in lower limb reconstructive surgery: random pattern flaps, axial flaps and free microsurgical transfers with many variants. After further research on the cutaneous blood supply and improvement of microsurgical techniques, perforator propeller flaps began to be studied and used. MATERIAL AND METHOD A propeller flap is defined as an insular fl...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 3 شماره
صفحات -
تاریخ انتشار 2012