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A review of propeller flaps for distal lower extremity soft tissue reconstruction: Is flap loss too high?
Author(s) -
Nelson Jonas A.,
Fischer John P.,
Brazio Philip S.,
Kovach Stephen J.,
Rosson Gedge D.,
Rad Ariel N.
Publication year - 2013
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.22134
Subject(s) - medicine , propeller , perforator flaps , surgery , microsurgery , context (archaeology) , soft tissue , anastomosis , free flap , marine engineering , paleontology , engineering , biology
Soft tissue coverage in the distal lower extremity remains a significant challenge. While free flaps are often utilized for larger defects, local perforator‐based propeller flaps may be ideal for smaller wounds requiring coverage. Propeller flaps can provide excellent form and function for both traumatic and atraumatic defects with minimal donor site morbidity but can have concerning rates of flap loss. We reviewed the literature, identifying 21 studies presenting 310 propeller flaps for distal lower extremity reconstruction. Total flap necrosis was noted in 5.5% of flaps, with partial necrosis in 11.6%. While these flaps do enable transfer of local, healthy tissue to the defect site without the need for a microsurgical anastomosis, this rate of flap loss is concerning and appropriate patient selection is crucial. This review provides a brief history and overview of the clinical application and research into distal lower extremity perforator propeller flaps to place this technique into a clinical context. © 2013 Wiley Periodicals, Inc. Microsurgery 33:578–586, 2013.