title: The "Tokyo" consensus on propeller flaps.
abstract: BACKGROUND
  Over the past few years, the use of propeller flaps, which base their blood supply on subcutaneous tissue or isolated perforators, has become increasingly popular. Because no consensus has yet been reached on terminology and nomenclature of the propeller flap, different and confusing uses of the term can be found in the literature.
  
  
  METHODS
  In this article, the authors report the consensus on the definition and classification of propeller flaps reached by the authors that gathered at the First Tokyo Meeting on Perforator and Propeller Flaps in June of 2009. Some peculiar aspects of the surgical technique are discussed.
  
  
  RESULTS
  A propeller flap can be defined as an "island flap that reaches the recipient site through an axial rotation." The classification is based on the nourishing pedicle (subcutaneous pedicled propeller flap, perforator pedicled propeller flap, supercharged propeller flap), the degrees of skin island rotation (90 to 180 degrees) and, when possible, the artery of origin of the perforator.
  
  
  CONCLUSIONS
  The propeller flap is a useful reconstructive tool that can achieve good cosmetic and functional results. A flap should be called a propeller flap only if it fulfils the definition above. The type of nourishing pedicle, the source vessel (when known), and the degree of skin island rotation should be specified for each flap.
authors.affiliation: West Sussex, United Kingdom; Tokyo, Japan; Allentown, Pa.; Bishkek, Kyrgyzstan; Cluj-Napoca, Romania; Kilpauk, Chennai, India; and Palermo, Italy From the Department of Plastic Surgery, Queen Victoria Hospital NHS Foundation Trust; Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School; Division of Plastic Surgery, Sacred Heart Hospital and The Lehigh Valley Hospitals; Department of Plastic, Reconstructive Microsurgery, and Hand Surgery, National Hospital of Kyrgyzstan; Plastic Surgery and Reconstructive Microsurgery Clinic, University of Medicine "Iuliu Hatieganu"; Plastic and Hand Surgery, Right Hospitals; Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Universita" degli Studi di Palermo; and Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo.
authors.forename: Marco
authors.initials: M
authors.lastname: Pignatti
authors.forename: Rei
authors.initials: R
authors.lastname: Ogawa
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Hallock
authors.forename: Musa
authors.initials: M
authors.lastname: Mateev
authors.forename: Alexandru V
authors.initials: AV
authors.lastname: Georgescu
authors.forename: Govindasamy
authors.initials: G
authors.lastname: Balakrishnan
authors.forename: Shimpei
authors.initials: S
authors.lastname: Ono
authors.forename: Tania C S
authors.initials: TCS
authors.lastname: Cubison
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Arpa
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
authors.forename: Hikko
authors.initials: H
authors.lastname: Hyakusoku
mesh_terms: D006801:Humans; D013524:Surgical Flaps / Q000009:adverse effects / Q000098:blood supply* / Q000145:classification; D009626:Terminology as Topic