title: Transversally oriented pedicled perforator flaps: A reliable alternative for lower leg reconstruction.
abstract: BACKGROUND
  The use of a transverse pattern for perforator flap design and its possible clinical applications in the field of lower leg reconstruction are previously unreported in the medical literature. The purpose of this report is to describe our clinical experience with the use of transversally oriented pedicled perforator flaps in lower leg reconstruction.
  
  
  METHODS
  Seven patients underwent lower leg reconstruction with transversally oriented pedicled perforator flaps. Patients age ranged from 42 to 68 years. All defects resulted from skin cancer ablation. Defect sizes ranged from 9 × 5 to 5 × 2.5 cm. The technique was applied to patients presenting with vertically oriented, long, and narrow defects, not feasible for primary closure, with the only audible perforators detected at a significant distance from the wound.
  
  
  RESULTS
  All flaps were based on a single perforator vessel. One of them was converted to a perforator-plus peninsular flap design, which retained an additional source of blood supply from the opposite skin bridge. The flaps were always mobilized in V-Y fashion. Donor sites were always closed primarily. Flap dimensions ranged from 15 × 7 to 8 × 3.5 cm. Operative time ranged from 40 to 90 minutes. All flaps survived uneventfully. Follow-up ranged from 6 months to 2 years. All patients were satisfied with the surgical outcome.
  
  
  CONCLUSIONS
  The use of transversally oriented pedicled perforator flaps proved to be a reliable alternative option to reconstruct small to medium size defects of the lower leg.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico Di Roma" University, via Alvaro Del Portillo, 200, Rome, 00128, Italy.
authors.forename: Beniamino
authors.initials: B
authors.lastname: Brunetti
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico Di Roma" University, via Alvaro Del Portillo, 200, Rome, 00128, Italy.
authors.forename: Igor
authors.initials: I
authors.lastname: Poccia
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico Di Roma" University, via Alvaro Del Portillo, 200, Rome, 00128, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Tenna
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico Di Roma" University, via Alvaro Del Portillo, 200, Rome, 00128, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Campa
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico Di Roma" University, via Alvaro Del Portillo, 200, Rome, 00128, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Persichetti
mesh_terms: D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery*; D016896:Treatment Outcome