title: Reconstruction of cubital fossa skin necrosis with radial collateral artery perforator-based propeller flap (RCAP).
abstract: In recent years, perforator flaps have become an indispensable tool for the reconstruction process. Most recently, "propeller" perforator flaps allow each perforator vessels to become a flap donor site. Once the perforator of interest is identified by acoustic Doppler, the cutaneous or fascio-cutaneous island is designed and then customized according to the principle of "perforasome". So, the flap can be rotated such a propeller, up to 180°. Ideally the donor site is self-closing, otherwise it can be grafted at the same time. Through a skin necrosis secondary to a contrast medium extravasation of the cubital fossa in a 47-year-old man, we describe the use of propeller perforator flap based on a perforator of the radial collateral artery (RCAP). The perforator was identified preoperatively by acoustic Doppler then the flap was adapted bespoke to cover the loss of substance. Ultimately, the result was very satisfying. Well experienced for lower-extremity reconstruction, perforator-based propeller flap are still few reported for upper limb. It is likely that in the future, propeller flap supersede in many indication not only free flaps and locoregional flaps but also, leaving no room for uncertainties of the vascular network, the classic random flaps.
authors.affiliation: Plastic and reconstructive surgery unit, faculty of medicine, university Toulouse Rangueil, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse, France. Electronic address: Benoitchaput31@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Chaput
authors.affiliation: Plastic and reconstructive surgery unit, faculty of medicine, university Toulouse Rangueil, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse, France.
authors.forename: S
authors.initials: S
authors.lastname: Gandolfi
authors.affiliation: Plastic and reconstructive surgery unit, Léon-Bérard institute, 28, rue Laennec, 69008 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Ho Quoc
authors.affiliation: Plastic and reconstructive surgery unit, faculty of medicine, university Toulouse Rangueil, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Chavoin
authors.affiliation: Plastic and reconstructive surgery unit, faculty of medicine, university Toulouse Rangueil, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse, France.
authors.forename: I
authors.initials: I
authors.lastname: Garrido
authors.affiliation: Plastic and reconstructive surgery unit, faculty of medicine, university Toulouse Rangueil, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Grolleau
mesh_terms: D001158:Arteries; D062109:Dermatologic Surgical Procedures / Q000379:methods; D004550:Elbow; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D061525:Perforator Flap / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012867:Skin / Q000473:pathology*
keywords: Cubital fossa; Elbow; Lambeau en hélice; Perforante de l’artère collatérale radiale; Pli du coude; Propeller flap; Radial collateral artery perforator