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J Reconstr Microsurg 2013; 29(08): 523-530
DOI: 10.1055/s-0033-1348900
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fate of a Second Perforator Free Flap Used to Salvage Failure of the First Perforator Free Flap

Geoffrey G. Hallock
1   Division of Plastic Surgery, Sacred Heart Hospital, Allentown, Pennsylvania
2   Division of Plastic Surgery, The Lehigh Valley Hospital, Allentown, Pennsylvania
3   Division of Plastic Surgery, St. Luke's Hospital, Bethlehem, Pennsylvania
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Further Information

Publication History

20 January 2013

17 May 2013

Publication Date:
12 July 2013 (online)

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Abstract

Perforator flaps should no longer be considered an exotic or complicated option for microsurgical tissue transfer. However, despite a proper design and attention to detail, as with any free flap, failure can be anticipated sometimes to occur. If a free flap is then still indicated, the big question is what to do next? In our series of 314 perforator free flaps over the past decade, 21 (7%) total failures occurred. A second free flap was attempted for 17 (81%) of these cases. Overall these were successful for 16 (94%) patients, including 11 perforator free flaps that were 100% successful. The anterolateral thigh (ALT) free flap proved to be the “workhorse” alternative. It can be concluded that if failure of a free flap can best be rectified by a second free flap, failure of a perforator free flap can also be reliably salvaged by a second perforator free flap.

Keywords

failed free flaps - perforator flaps - anterolateral thigh flap
 

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