Shoeib, M., Youssef, G., Gaber, A., Saber, A., Gomaa, E. (2019). Propeller Flaps for Reconstructing Leg and Foot Defects: The Relation between Flap Length and the Incidence of Ischemia. The Egyptian Journal of Plastic and Reconstructive Surgery, 43(2), 243-249. doi: 10.21608/ejprs.2019.65080
M A Shoeib; Gamal Youssef; Ahmed Gaber; Ahmed Saber; Emad Gomaa. "Propeller Flaps for Reconstructing Leg and Foot Defects: The Relation between Flap Length and the Incidence of Ischemia". The Egyptian Journal of Plastic and Reconstructive Surgery, 43, 2, 2019, 243-249. doi: 10.21608/ejprs.2019.65080
Shoeib, M., Youssef, G., Gaber, A., Saber, A., Gomaa, E. (2019). 'Propeller Flaps for Reconstructing Leg and Foot Defects: The Relation between Flap Length and the Incidence of Ischemia', The Egyptian Journal of Plastic and Reconstructive Surgery, 43(2), pp. 243-249. doi: 10.21608/ejprs.2019.65080
Shoeib, M., Youssef, G., Gaber, A., Saber, A., Gomaa, E. Propeller Flaps for Reconstructing Leg and Foot Defects: The Relation between Flap Length and the Incidence of Ischemia. The Egyptian Journal of Plastic and Reconstructive Surgery, 2019; 43(2): 243-249. doi: 10.21608/ejprs.2019.65080
Propeller Flaps for Reconstructing Leg and Foot Defects: The Relation between Flap Length and the Incidence of Ischemia
The Department of Plastic Surgery, Sohag University Hospital, Sohag, Egypt
Abstract
Background: Reconstruction of soft tissue defects in the leg and the foot remains challenging. Anatomical constraints limit the options available for reconstructing complex defects especially lower third of leg. Perforator propeller flaps are raising interest in reconstructive surgery of the limbs. We present our experience with perforator propeller flaps for reconstruction of soft tissue defects in leg and foot with an emphasis on the safe limit of a perforator flap in the lower limb. Methods: The study was carried prospectively and 32 patients with leg or foot defects treated with various perforator propeller flaps (both elective as well as emergency) were included in the study. A hand-held ultrasound Doppler was used pre-operatively and intraoperatively to detect the perforator vessels. Results: Out of the 32 cases, we witnessed total flap loss in one and distal necrosis in 6 cases. In 4 of them the flaps lengths were more than one third of the limb length. 8 patients had minor complications which included congestion, infection or graft loss. Conclusion: Perforator flaps may represent a good alternative to the free flaps in the areas were other local reconstructive procedures are not possible. This is a versatile technique and with decreased donor site morbidity limited to a single body area. There is a specific like to like soft tissue replacement leading to a better cosmetic and reconstructive outcome. The main drawback of the perforator flaps however is the higher risk of venous congestion. The incidence of distal necrosis increases with flap length more than one third of the limb provided other factors affecting flap vitality are constant.
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