The use of pedicled perforator flaps for reconstruction of lumbosacral defects.
Large lumbosacral defects remain a difficult challenge in reconstructive surgery, especially in the nonparaplegic patient. Traditional options for closure include local rotation or transposition flaps and musculocutaneous flaps. These flaps, however, are not an optimal option in previously irradiated or operated areas, or in cases of large defects. Application of the perforator principle to the traditional musculocutaneous flap creates perforator flaps, which are an additional tool in the treatment of these defects in the nonparaplegic patient. A large amount of healthy, well-vascularized tissue can be transferred on one perforator without sacrificing important underlying muscles. The arc of rotation is also larger than in traditional flaps. The authors present an anatomic overview of three types of pedicled perforator flaps: the superior gluteal artery perforator flap, the lumbar artery perforator flap, and the intercostal artery perforator flap. They also report 4 patients in whom a pedicled perforator flap was used to reconstruct a large lumbosacral defect.
Department of Plastic and Reconstructive Surgery, University Hospital Gent, Belgium.
N A
NA
Roche
K
K
Van Landuyt
P N
PN
Blondeel
G
G
Matton
S J
SJ
Monstrey
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008161:Lumbosacral Region / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps