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CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2023; 08(01): e45-e50
DOI: 10.1055/a-2086-4988
Original Article

Perfusion Changes in Perforator-Based Propeller Flaps

Silvia Bernuth
1   Department of Plastic and Reconstructive Surgery, Clinic of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
,
Adrian Vater
1   Department of Plastic and Reconstructive Surgery, Clinic of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
,
Konrad F. Fuchs
2   Clinic of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
,
Rainer H. Meffert
2   Clinic of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
,
Rafael G. Jakubietz
1   Department of Plastic and Reconstructive Surgery, Clinic of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
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Abstract

Background To cover soft tissue defects, the perforator-based propeller flap offers the option to rotate healthy tissue into complex wounds. By rotating the flap, the perforator is torqued. As a result, perfusion changes are possible.

Methods A retrospective data analysis of patients was done, who received a propeller flap to cover soft tissue defects of the lower extremity as well as a peri- and postoperative perfusion monitoring with a laser-Doppler-spectrophotometry system. Additionally, patient-specific data were collected.

Results Seven patients were identified. Four patients experienced early complications, two epidermolysis of the distal flap areas, three wound healing disorders, and one partial flap necrosis. Intraoperative perfusion monitoring showed a decline of blood flow after incision of the flap, especially at distal flap site. In case of complications, there were prolonged blood flow declines up to the first postoperative day.

Conclusion Torqueing the perforator by rotating the flap can cause an impairment in inflow and outflow. If the impairment is prolonged, perfusion-associated complications are possible. The identification of a viable perforator is particularly important. In addition, a conservative postoperative mobilization is necessary to compensate for the impaired and adapting outflow.

Keywords

propeller flap - perfusion - lower extremity


Publication History

Received: 25 October 2022

Accepted: 28 February 2023

Accepted Manuscript online:
04 May 2023

Article published online:
13 June 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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