Definition of perforator flap: what does a "perforator" perforate?

Perforator flap microsurgery reconstruction supermicrosurgery surgery

Journal

Global health & medicine
ISSN: 2434-9194
Titre abrégé: Glob Health Med
Pays: Japan
ID NLM: 101771579

Informations de publication

Date de publication:
31 Dec 2019
Historique:
received: 29 07 2019
revised: 08 12 2019
accepted: 15 12 2019
entrez: 17 12 2020
pubmed: 18 12 2020
medline: 18 12 2020
Statut: ppublish

Résumé

Perforator flap concept plays an important role in reconstructive surgery, because it allows less invasive and more complex reconstruction by preserving major vessels and muscles with intramuscular vessel dissection. Originally "perforator" represents vessel perforating the muscle, then vessel perforating the deep fascia regardless of muscle perforation. With technical progress in reconstructive microsurgery, the previous definition becomes inappropriate for least invasive flaps, only requiring intra-adiposal vessel dissection, such as superficial circumflex iliac artery perforator flap. Based on our experience of various least invasive flap reconstructive surgeries, a new concept for perforator flap has been developed. The new definition of perforator is a vessel perforating an envelope of a targeted tissue to be transferred; the superficial fascia for skin, the periosteum for bone, the perineurium for nerve, and the deep fascia for muscle. According to the new definition, all flaps can be precisely classified based on the corresponding "perforator".

Identifiants

pubmed: 33330765
doi: 10.35772/ghm.2019.01009
pmc: PMC7731185
doi:

Types de publication

Journal Article

Langues

eng

Pagination

114-116

Informations de copyright

2019, National Center for Global Health and Medicine.

Références

Ann Plast Surg. 2014 Feb;72(2):246-52
pubmed: 23340458
Plast Reconstr Surg. 1993 Sep;92(3):411-20
pubmed: 8341739
Microsurgery. 2018 Jul;38(5):589-590
pubmed: 29473214
Br J Plast Surg. 1989 Nov;42(6):645-8
pubmed: 2605399
J Plast Reconstr Aesthet Surg. 2016 Sep;69(9):1260-5
pubmed: 27423250
Microsurgery. 2015 May;35(4):324-7
pubmed: 25446070
Plast Reconstr Surg. 1977 Sep;60(3):341-52
pubmed: 142995
Plast Reconstr Surg. 2003 Oct;112(5):1378-83; quiz 1383, 1516; discussion 1384-7
pubmed: 14504524
J Plast Reconstr Aesthet Surg. 2016 Sep;69(9):1227-33
pubmed: 27449876
Br J Plast Surg. 2005 Jun;58(4):431-40
pubmed: 15897023

Auteurs

Takumi Yamamoto (T)

Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan.

Nana Yamamoto (N)

Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan.

Takashi Kageyama (T)

Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan.

Hayahito Sakai (H)

Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan.

Yuma Fuse (Y)

Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan.

Kanako Tsuihiji (K)

Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan.

Reiko Tsukuura (R)

Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan.

Classifications MeSH