title: Propeller flap reconstruction of abdominal defects: review of the literature and case report.
abstract: The abdominal wall is perfused anteriorly by the superior and deep epigastric vessels with a smaller contribution from the superficial system. The lateral abdominal wall is perfused predominantly from perforators arising from the intercostal vessels. Reconstruction of soft tissue defects involving the abdomen presents a difficult challenge for reconstructive surgeons. Pedicle perforator propeller flaps can be used to reconstruct defects of the abdomen, and here we present a thorough review of the literature as well as a case illustrating the perforasome propeller flap concept. A patient underwent resection for dermatofibrosarcoma protuberans resulting in a large defect of the epigastric soft tissue. A propeller flap was designed based on a perforator arising from the superior deep epigastric vessels and was rotated 90° into the defect allowing primary closure of the donor site. The patient healed uneventfully and was without recurrent disease 37 months following reconstruction. Perforator propeller flaps can be used successfully in reconstruction of abdominal defects and should be incorporated into the armamentarium of reconstructive microsurgeons already facile with perforator dissections.
authors.affiliation: Department of Plastic Surgery, Ospedali Riuniti di Ancona, Univerista' Politecnica delle Marche, Ancona, Italy; Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX.
authors.forename: Mario F
authors.initials: MF
authors.lastname: Scaglioni
authors.forename: Alberto Di
authors.initials: AD
authors.lastname: Giuseppe
authors.forename: Edward I
authors.initials: EI
authors.lastname: Chang
mesh_terms: D000008:Abdominal Neoplasms / Q000601:surgery*; D034861:Abdominal Wall / Q000098:blood supply / Q000601:surgery; D000368:Aged; D002921:Cicatrix / Q000601:surgery; D018223:Dermatofibrosarcoma / Q000601:surgery*; D019074:Epigastric Arteries / Q000601:surgery*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008866:Microsurgery / Q000379:methods*; D009392:Nephrectomy; D061525:Perforator Flap / Q000098:blood supply* / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012983:Soft Tissue Neoplasms / Q000098:blood supply* / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply* / Q000601:surgery*; D020858:Tissue and Organ Harvesting / Q000379:methods