title: Free-style local perforator flaps: versatility of the v-y design to reconstruct soft-tissue defects in the skin cancer population.
abstract: BACKGROUND
  Free-style local perforator flaps can be harvested from any region of the body where an appropriate and detectable perforator vessel is present. Their use allows the surgeon to perform a "like with like" reconstruction by mobilizing surrounding tissues on a consistent vascular source. The authors report their experience with V-Y free-style perforator flaps in reconstruction of soft-tissue defects subsequent to skin cancer excision.
  
  
  METHODS
  Forty elective defects in different regions of the body were reconstructed with V-Y advancement local perforator flaps raised in a free-style fashion. There were 23 male patients and 17 female patients. Mean age at surgery was 63 years. All defects resulted from skin cancer ablation. Mean defect size was 5×3.7 cm. Mean flap dimensions were 8.8×4.2 cm. The flaps were based on one (n=10), two (n=18), or three (n=12) perforators.
  
  
  RESULTS
  Mean operative time was 93 minutes. Thirty-seven flaps (92.5 percent) healed uneventfully. In three flaps (7.5 percent), moderate venous insufficiency occurred, leading to partial flap necrosis that required surgical revision. In three cases (7.5 percent), the flap was converted to a rotation/hatchet perforator-based peninsular flap. Slight venous stasis was the most common postoperative finding registered (eight flaps; 20 percent). All flaps achieved adequate and durable reconstruction with excellent contour, with a follow-up ranging between 6 months and 2 years.
  
  
  CONCLUSIONS
  Free-style local perforator flaps advanced in V-Y fashion proved to be a valid and reliable solution to restore function and aesthetics of the operated site after skin cancer excision.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Rome, Italy From the Plastic, Reconstructive, and Aesthetic Surgery Unit, Campus Bio-Medico of Rome University.
authors.forename: Beniamino
authors.initials: B
authors.lastname: Brunetti
authors.forename: Stefania
authors.initials: S
authors.lastname: Tenna
authors.forename: Achille
authors.initials: A
authors.lastname: Aveta
authors.forename: Francesco
authors.initials: F
authors.lastname: Segreto
authors.forename: Paolo
authors.initials: P
authors.lastname: Persichetti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply*; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D017695:Soft Tissue Injuries / Q000601:surgery; D035441:Thoracic Wall / Q000601:surgery; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000601:surgery; D034941:Upper Extremity / Q000601:surgery; D014945:Wound Healing / Q000502:physiology*
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