BACKGROUND Selection of a vascular pedicle for autologous breast reconstruction is time consuming and depends on visual evaluation during the surgery. Preoperative imaging of donor site for mapping the perforator artery anatomy greatly improves the efficiency of perforator selection and significantly reduces the operative time. In this article, we present our experience with magnetic resonance ...

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...

Background and objectives: Perforator flaps, both pedicled and free flaps, are increasingly used in reconstructive surgery. However, the microvascular perfusion pattern within these flaps still remains essentially unknown. It is well known that in random-pattern flaps, flap length correlates directly with the width of the flap base. In perforator flaps, the importance of preserving a skin base ...

Large full-thickness chest wall reconstruction requires an alloplastic material to ensure chest wall stability, as well as a flap that provides good soft-tissue coverage. The choice not to use perforator flaps over any mesh or inert material is often based on the concern that the vascularization would be inadequate. However, perforator flaps have shown good results in several reconstructive fie...

The propeller-type flap design is increasingly used in reconstructive surgery for various regions of the body. To date, determinants of perforator patency when subjected to twisting have not been elucidated. We propose a simulation model to study parameters affecting perforator patency under such conditions. Nonlinear finite element procedure was used to simulate a perforator consisting of an a...

BACKGROUND The profunda artery perforator flap has been emerging as an alternative method of autologous breast reconstruction. This flap uses upper posterior thigh tissue. The profunda artery perforator perforasome is investigated using three-dimensional computed tomographic angiography. METHODS Ten cadaveric thighs were dissected centered over the profunda artery perforator. The perforator w...

In 2009, we have described the use of freestyle facial artery perforator flaps for one-stage nose reconstruction. Since then, several articles have reported the use of facial artery perforator flaps for nose reconstruction. The purpose of this article is to provide an update of the published technique after 10 years of experience. Since 2004, 21 patients have been treated with a freestyle facia...

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...

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 ...