Freestyle Perforator Puzzle Flap for Posterior Trunk Reconstruction.
Journal
Annals of plastic surgery
ISSN: 1536-3708
Titre abrégé: Ann Plast Surg
Pays: United States
ID NLM: 7805336
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
pubmed:
28
1
2020
medline:
15
5
2021
entrez:
28
1
2020
Statut:
ppublish
Résumé
Closure of extensive defects of posterior trunk can be challenging for reconstructive surgeons owing to the need of a large bulk of well-vascularized tissue to resurface the skin and the exposed hardware and to fill the dead spaces. We hypothesized that elevating multiple perforators flaps in various patterns would allow for reconstruction of large posterior trunk defects with tension-free primary closure and minimal donor site morbidity. Between January 2013 and December 2016, 23 patients with large posterior trunk defects underwent reconstruction with a multiple freestyle perforator flaps approach. We experimented a freestyle perforator-based reconstruction, which consists of designing a sequence of flaps, able to adequately fit the defects, allowing for tensionless primary closure. The average age of patients was 60.2 years (range, 18-80 years). A total number of 62 perforator flaps was performed, with an average of 2.6 flaps per patient. We were able to successfully cover defects up to 27 × 29 cm. A single perforator was used in 58 flaps, whereas more than 1 perforator was applied in 4 flaps. In all cases, the donor sites were closed primarily, and patients healed uneventfully. Six patients underwent radiotherapy after surgery, but no complication occurred. In this series of extensive defects of the posterior trunk, a tension-free closure was achieved by distributing the tension to multiple freestyle perforator flaps, supplying sufficient volume of tissue and reliable vascularization. This approach can be a valid tool in facing reconstruction of large and complicated defects of the posterior trunk.
Sections du résumé
BACKGROUND
Closure of extensive defects of posterior trunk can be challenging for reconstructive surgeons owing to the need of a large bulk of well-vascularized tissue to resurface the skin and the exposed hardware and to fill the dead spaces. We hypothesized that elevating multiple perforators flaps in various patterns would allow for reconstruction of large posterior trunk defects with tension-free primary closure and minimal donor site morbidity.
PATIENTS AND METHODS
Between January 2013 and December 2016, 23 patients with large posterior trunk defects underwent reconstruction with a multiple freestyle perforator flaps approach. We experimented a freestyle perforator-based reconstruction, which consists of designing a sequence of flaps, able to adequately fit the defects, allowing for tensionless primary closure.
RESULTS
The average age of patients was 60.2 years (range, 18-80 years). A total number of 62 perforator flaps was performed, with an average of 2.6 flaps per patient. We were able to successfully cover defects up to 27 × 29 cm. A single perforator was used in 58 flaps, whereas more than 1 perforator was applied in 4 flaps. In all cases, the donor sites were closed primarily, and patients healed uneventfully. Six patients underwent radiotherapy after surgery, but no complication occurred.
CONCLUSIONS
In this series of extensive defects of the posterior trunk, a tension-free closure was achieved by distributing the tension to multiple freestyle perforator flaps, supplying sufficient volume of tissue and reliable vascularization. This approach can be a valid tool in facing reconstruction of large and complicated defects of the posterior trunk.
Identifiants
pubmed: 31985540
doi: 10.1097/SAP.0000000000002259
pii: 00000637-202007000-00011
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
56-60Références
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