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DOI: 10.1055/s-2006-941717
Pedicled Perforator Flaps for the Lower Limb
Publikationsverlauf
Publikationsdatum:
29. Mai 2006 (online)
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ABSTRACT
The use of local perforator-based flaps for reconstruction of soft tissue defects of the lower extremity is a simple and safe alternative to the more complex and time-consuming microsurgical reconstructions. This has been made possible through better understanding of the cutaneous circulation and local vascular anatomy and innovations in flap design. This review describes the evolution, technique, and modifications of pedicled perforator-based flaps, particularly in the reconstruction of posttraumatic defects of the lower third of the leg. Attention is focused on the perforator-based posterior tibial, adipofascial, and dorsal foot flaps. We also highlight the concept of the ad hoc perforator flap, a flap that decreases dependence on preconceived designs.
KEYWORDS
Leg - local flap - perforator flap
REFERENCES
- 1 Ger R. The technique of muscle transposition in the operative treatment of traumatic and ulcerative lesions of the leg. J Trauma. 1971; 11 502-510
- 2 Ponten B. The fasciocutaneous flap: its use in soft tissue defects of the lower leg. Br J Plast Surg. 1981; 34 215-220
- 3 Chatre M G, Quaba A A. Fasciocutaneous flaps in lower leg reconstructions: experience with 100 flaps. Presented at the British Association of Plastic Surgeons, Summer Meeting July 2, 1987 Edinburgh, Scotland;
- 4 Carriquiry C, Costa M A, Vasconez L O. An anatomic study of the septocutaneous vessels of the leg. Plast Reconstr Surg. 1985; 76 354-363
- 5 Song R, Gao Y, Song Y, Yu Y, Song Y. The forearm flap. Clin Plast Surg. 1982; 9 21-26
-
6 Quaba A A.
Local flaps . In: Court-Brown CM, McQueen MM, Quaba AA Management of Open Fractures. London; Martin Dunitz Publishers 1996: 195-209 -
7 Court-Brown C M, Quaba A A.
The relationship between plastic surgery and orthopaedic trauma surgery . In: Court-Brown CM, McQueen MM, Quaba AA Management of Open Fractures. London; Martin Dunitz Publishers 1996: 157-164 - 8 Erdmann M WH, Court-Brown C M, Quaba A A. A five-year review of islanded distally based fasciocutaneous flaps on the lower limbs. Br J Plast Surg. 1997; 50 421-427
- 9 Keating J F, Court-Brown C M, Quaba A A. Open tibial fractures. Presented at the American Academy of Orthopaedic Surgeons, Annual Meeting February 5, 1994 New Orleans, LA;
- 10 Horlock N, Pirayesh A, Teo T. The propeller flap: an elegant refinement to the reverse flow fasciocutaneous flap in distal lower limb reconstruction. Presented at the Fifth International Course on Perforator Flaps September 28, 2001 Gent, Belgium;
- 11 Niranjan N S, Price R D, Govilkar P. Fascial feeder and perforator-based V-Y advancement flaps in the reconstruction of lower limb defects. Br J Plast Surg. 2000; 53 679-689
- 12 Lai C S, Lin S D, Yang C C, Chou C K. Adipofascial turn-over flap for reconstruction of the dorsum of the foot. Br J Plast Surg. 1991; 44 170-174
- 13 Sarhadi N S, Quaba A A. Experience with the adipofascial turnover flap. Br J Plast Surg. 1993; 46 307-313
- 14 Lin S D, Lai C S, Chou C K, Tsai C W, Tsai C C. Reconstruction of soft tissue defects of the lower leg with the distal based medial adipofascial flap. Br J Plast Surg. 1994; 47 132-137
- 15 Wilson Y T, Quaba A A. Experience with the perforator based adipofascial flap for cover of compound tibial fractures. Presented at the British Association of Plastic Surgeons, Winter Meeting December 5, 1996 London, UK;
- 16 Taylor G I, Palmer J H. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg. 1987; 40 113-141
- 17 Earley M J, Milner R H. A distally-based first web flap in the foot. Br J Plast Surg. 1989; 42 507-511
- 18 Man D, Acland R D. The microarterial anatomy of the dorsalis pedis flap and its clinical applications. Plast Reconstr Surg. 1980; 65 419-423
- 19 Bharathwaj V S, Quaba A A. The distally based island dorsal foot flap. Br J Plast Surg. 1997; 50 284-287
- 20 Quaba A A, Davison P M. The distally-based dorsal hand flap. Br J Plast Surg. 1990; 43 28-39
- 21 Fitzgerald A, Quaba A A. Ad hoc perforator local flaps. Presented at the combined meeting of the British Association of Plastic Surgeons and the Plastic Surgery Educational Foundation of the USA December 3, 1998 London, UK;
- 22 Hallock G G. Direct and indirect perforator flaps: the history and the controversy. Plast Reconstr Surg. 2003; 111 855-865
- 23 Wei F C, Mardini S. Free-style free flaps. Plast Reconstr Surg. 2004; 114 910-916
Awf QuabaF.R.C.S. Ed. Plast.
Consultant Plastic Surgeon, St. John's Hospital, Howden Road West
Livingston, Scotland, United Kingdom EH54 6PP