title: Perforator-based propeller flaps treating loss of substance in the lower limb.
abstract: BACKGROUND
  Local flaps based on perforator vessels are raising interest in reconstructive surgery of the limbs. These flaps allow efficient coverage of large wounds without the need to sacrifice a major vascular axis. The operative technique does not require microvascular anastomosis and allows reconstruction of soft tissue defects using nearby similar tissues. The aim of this study was to evaluate the clinical results of local perforator flaps in the treatment of complex lower-limb defects.
  
  
  METHODS
  Twenty-two local perforator flaps were retrospectively studied. Loss of substance was due to postsurgical complications in seven cases, oncological resection in six, posttraumatic defect in five, pressure sores in three, and osteomyelitis in one.
  
  
  RESULTS
  Postoperatively, two patients showed partial flap necrosis. In five patients, a superficial epidermolysis occurred. Minor complications were seen in three patients who showed transient venous congestion of the flap. Furthermore, transient leg edema was sometimes observed in patients with large propeller flaps. All but one patient healed without further major surgical procedures. In three cases, secondary skin grafts were performed. In most cases, the aesthetic result was optimal and patients were fully satisfied.
  
  
  CONCLUSIONS
  When characteristics of the defect are suitable for treatment with a propeller-based local flap, this technique should be considered as one of reasonable options for surgical reconstruction. Microsurgical techniques facilitate the management of complex trauma in emergency and may allow planning reconstructive procedures and limb salvage in elective orthopedic surgery.
authors.affiliation: Department of Orthopedics and Traumatology, UOD Reconstructive Microsurgery, CTO-M, Adelaide, Turin, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Tos
authors.forename: Marco
authors.initials: M
authors.lastname: Innocenti
authors.forename: Stefano
authors.initials: S
authors.lastname: Artiaco
authors.forename: Andrea
authors.initials: A
authors.lastname: Antonini
authors.forename: Luca
authors.initials: L
authors.lastname: Delcroix
authors.forename: Stefano
authors.initials: S
authors.lastname: Geuna
authors.forename: Bruno
authors.initials: B
authors.lastname: Battiston
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply*; D016909:Tibial Arteries / Q000601:surgery; D055815:Young Adult