title: Reconstruction of Heel With Propeller Flap in Postfasciotomy and Popliteal Artery Revascularization State.
abstract: Free flaps are still the gold standard for large defects of the lower limb, but propeller perforator flaps have become a simpler and faster alternative to free flaps because of some advantages such as reliable vascular pedicle, wide mobilization and rotation, great freedom in design, low donor site morbidity, and easy harvest with no requirement for anastomosis. But when the vessels show insufficient findings in preoperative evaluation using a Doppler probe or the vessel is injured, the surgeon should avoid performing free flap surgery to prevent flap failure and should select a propeller perforator flap as an alternative method on the condition that more than one perforator is intact. In this study, we report reconstruction of soft tissue defects of the heel with a pedicled propeller flap in postfasciotomy and popliteal artery revascularization state by making an incision on the central portion above the Achilles tendon, which can be covered by the posterior tibial artery perforator or the peroneal artery perforator based flaps. In conclusion, we showed that although the popliteal artery was injured, the soft tissue defect can be reconstructed using a perforator propeller flap if intact distal flow in the anastomosis site was confirmed.
authors: Department of Plastic & Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors: Jin Seok
authors: JS
authors: Kang
authors: Department of Plastic & Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea medi619@hanmail.net.
authors: Hwan Jun
authors: HJ
authors: Choi
authors: Department of Plastic & Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors: Min Sung
authors: MS
authors: Tak
mesh_terms: D000072226:Computed Tomography Angiography / Q000379:methods; D000071938:Fasciotomy / Q000379:methods*; D006365:Heel / Q000098:blood supply / Q000293:injuries / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000293:injuries / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000601:surgery; D013524:Surgical Flaps; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D014656:Vascular Surgical Procedures / Q000379:methods*; D057772:Vascular System Injuries / Q000175:diagnosis / Q000601:surgery
keywords: fasciotomy; heel; popliteal artery; propeller flap