Local perforator flaps have evolved over the time to provide complete and stable coverage of soft tissue defects. Technical advances and experience with the perforator flaps have allowed the harvest of local perforator flaps in a free style manner by offering greater freedom in flap selection. We have proposed a technical modification in the harvest of a perforator flap by relocating the perfor...

BACKGROUND Despite the most heroic efforts, sometimes free flaps fail. Perforator free flaps are not invincible and can suffer the same fate. The real challenge is how to decide what is the next best choice for achieving the desired outcome. METHODS Over the past decade, 298 free perforator flaps were used in our institution. Total failure occurred in 16 patients, and partial failure requirin...

The introduction of perforator flaps represented a significant advance in microsurgical reconstruction. However, confusion has developed due to the erroneous belief that perforator flaps are different from conventional flaps. The concept of the perforator is not new, but is an idea that evolved from the conventional flap. In fact, some of the flaps used by microsurgeons were perforator flaps. T...

INTRODUCTION Anatomy and classification of intercostal perforator flaps in addition to our experience with will be demonstrated for different indications. MATERIAL AND METHODS The intercostal vessels form an arcade between the aorta and the internal mammary vessels. Different pedicled perforator flaps can be raised on this neurovascular bundle to cover defects on the trunk. They are classifie...

UNLABELLED Background. Post-burn flexion contractures of the knee may arise even with adequate treatment of the burn injury. After release of the contracture, most of these defects require flap coverage. Here we describe the application of the perforator plus flap concept in the management of these contractures. Method. Between December 2010 and December 2011 five female and two male patients w...

There are numerous perforator flaps reported in the literature for head and neck reconstruction. We are presenting a case report of squamous cell carcinoma of Tongue which was operated by hemi glossectomy, modified radical neck dissection and reconstruction was done with medial sural artery perforator flap (MSAP). Preoperatively handheld Doppler was used to identify the perforator. The size of ...

813 free perforator flap surgery and always have a second option in mind in case of flap failure. Further, a sufficient understanding of the wound characteristics, donor and recipient vessels, and design for insetting should precede the surgery. Lastly, the skin graft over the muscle flap is less durable than the fasciocutaneous flap and tends to form a callus. To prevent this complication, a p...

Introduction. Soft tissue coverage of distal leg and ankle region represents a challenge and such defect usually requires a free flap. However, this may lead to considerable donor site morbidity, is time consuming, and needs facility of microsurgery. With the introduction of perforator flap, management of small- and medium-size defects of distal leg and ankle region is convenient, less time con...

BACKGROUND The deep inferior epigastric perforator flap is rapidly becoming a more widely employed method of autologous breast reconstruction. The technical considerations involved in the execution of the flap are many and include the selection of perforators to be incorporated in the flap. We attempt to give a mathematical explanation, based on the physics of flow through vessels and the prope...

OBJECTIVE The report herein presents a case of a 49-year-old woman with left breast cancer who presented seeking immediate autologous reconstruction. Surgical history included an abdominal hysterectomy and an abdominal contouring procedure. This is a first description of a deep inferior epigastric perforator flap after abdominal wall manipulation of this magnitude. METHODS Computed tomographi...