Use of Perforator-Based Fasciocutaneous Flaps for Pressure Sore Reconstruction: Single-Perforator-Based Versus Multiple-Perforator-Based Flaps.
BACKGROUND
A perforator-based fasciocutaneous flap is an alternative type of flap for pressure sore reconstruction. The aim of the present study was to determine whether a single-perforator-based flap or a multiple-perforator-based flap is better for pressure sore reconstruction.


METHODS
We reviewed the general data and postoperative complications in patients who received single-perforator-based or multiple-perforator-based fasciocutaneous flaps for pressure sore reconstruction between July 2009 and July 2012.


RESULTS
No differences in general data, comorbidities, wound locations, flap sizes (73.9 vs. 67.0 cm(2), P = 0.455), and operative times were noted between the single-perforator-based and multiple-perforator-based flap groups. The flap rotation arc was larger in the single-perforator-based flap group than in the multiple-perforator-based flap group; however, the difference in the rotation arc was not significant (99.2° vs. 55.5°, respectively; P = 0.199). Two patients had total flap necrosis and one had partial flap necrosis in the single-perforator-based flap group. None of flap necrosis was noted in the multiple-perforator-based flap group; however, no significant differences in major complications were noted between the two groups. All donor sites underwent primary closure.


CONCLUSIONS
This is the first clinical patient-matched research that considered the number of perforators and the rotation arc in applying perforator-based fasciocutaneous flaps in wound reconstruction. The results showed that the number of perforators is not the determinant factor of surgical outcome of the use of perforator-based fasciocutaneous flaps in pressure sore reconstruction. Thus, whether a single- or a multiple-perforator-based fasciocutaneous flap is used for flap perfusion does not jeopardize the operation. These results emphasize the reliability and convenience of using freestyle design of perforator-based flaps for pressure sore reconstruction. The design and clinical utility of the flaps have the advantage of being versatile.


METHODS
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Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, 19F., No. 201, Sec. 2, Linong St., Beitou Dist., Taipei, 112, Taiwan. linchihhsun640305@gmail.com.|National Yang-Ming University, Taipei, Taiwan. linchihhsun640305@gmail.com.
Lin
L
Chih-Hsun
Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, 19F., No. 201, Sec. 2, Linong St., Beitou Dist., Taipei, 112, Taiwan.|National Yang-Ming University, Taipei, Taiwan.
Hsu
H
Ma
D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000098:blood supply / Q000637:transplantation*; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D003668:Pressure Ulcer / Q000175:diagnosis / Q000601:surgery*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D014945:Wound Healing / Q000502:physiology*
Fasciocutaneous flap; Perforasome; Perforator; Pressure sore