title: Risk Factor Analysis of Freestyle Propeller Flaps.
abstract: BackgroundFreestyle propeller flaps have been widely used as a reconstructive option for both trunk and extremities. It offers the advantage of "like-with-like" reconstruction with an adjacent tissue with no dissection to the source vessels. However, there is the risk of vascular complications. In the present study, the authors investigated the incidence of vascular complications and their risk factors following freestyle propeller flap in the trunk and extremities.MethodsThe authors conducted a retrospective review of 50 patients who underwent soft tissue reconstruction of the trunk and the extremities with 55 freestyle propeller flaps from 2004 to 2015. Data regarding patient demographics, surgical details, including the arc of rotation, and flap complications were collected from a prospectively maintained database and analyzed.ResultsThere were 10 flap complications (18.2%), including 7 superficial partial necrosis, 2 full-thickness partial necrosis, and 1 total necrosis from the 55 freestyle propeller flaps harvested. Previous irradiation was a significant risk factor for flap complications and the propeller flap harvested from the extremities showed a significantly higher rate of complications compared with those harvested from the trunk. Complication rates were higher in flaps with the arc of rotation between 150 and 180 degrees with marginal significance compared with flaps with the arc of rotation less than 150 degrees.ConclusionsFreestyle propeller flaps proved to be a valid and reliable option for reconstruction of defects in the trunk, while complication rate was quite high in the extremities. A prudent preoperative evaluation and preparation may be necessary before performing this surgical technique in the extremities.
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Joo Myong
authors.initials: JM
authors.lastname: Paik
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Jai-Kyong
authors.initials: JK
authors.lastname: Pyon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009336:Necrosis / Q000601:surgery*; D061525:Perforator Flap / Q000098:blood supply*; D011183:Postoperative Complications / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000601:surgery*; D060726:Torso; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult