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DOI: 10.1055/s-0039-1695740
Thin Perforator Flaps for Reconstruction of the Lower Extremity
Funding None.Abstract
Thin flaps, a modification of traditional flaps that minimize the need for debulking and revision, offer unique advantages in the field of lower limb reconstruction. Advances in the field of microsurgery have made this streamlined method of reconstruction a viable solution for soft tissue coverage in patients with both trauma and nonhealing wounds. Better understanding of anatomy has allowed for flap harvest above the fascia level and the Scarpal plane. These modifications allow for flap transfer with thicknesses more comparable to the native anatomy of the lower leg, ankle, and foot. Flap survival is comparable to traditional techniques with greater potential for improved patient-centered outcomes.
Publikationsverlauf
Eingereicht: 06. Juni 2019
Angenommen: 18. Juli 2019
Artikel online veröffentlicht:
30. August 2019
© 2020. Thieme. All rights reserved.
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References
- 1 Seth AK, Iorio ML. Super-thin and suprafascial anterolateral thigh perforator flaps for extremity reconstruction. J Reconstr Microsurg 2017; 33 (07) 466-473
- 2 Hong JP, Choi DH, Suh H. et al. A new plane of elevation: the superficial fascial plane for perforator flap elevation. J Reconstr Microsurg 2014; 30 (07) 491-496
- 3 Kimura N, Satoh K, Hasumi T, Ostuka T. Clinical application of the free thin anterolateral thigh flap in 31 consecutive patients. Plast Reconstr Surg 2001; 108 (05) 1197-1208 , discussion 1209–1210
- 4 Nalamlieng MD, Gould DJ, Patel KM. Ultrathin free flaps to the foot and ankle: new options for optimal soft tissue coverage and functional contour. J Foot Ankle Surg 2019; 58 (04) 802-806
- 5 Rounds AD, Burtt KE, Leland HA. et al. Functional outcomes of traumatic lower extremity reconstruction. J Clin Orthop Trauma 2019; 10 (01) 178-181
- 6 Economides JM, Patel KM, Evans KK, Marshall E, Attinger CE. Systematic review of patient-centered outcomes following lower extremity flap reconstruction in comorbid patients. J Reconstr Microsurg 2013; 29 (05) 307-316
- 7 Patel KM, Economides JM, Franklin B, Sosin M, Attinger C, Ducic I. Correlating patient-reported outcomes and ambulation success following microsurgical lower extremity reconstruction in comorbid patients. Microsurgery 2014; 34 (01) 1-4
- 8 Patel KM, Mantell M, Sosin M, Ramineni P. Chimeric functional latissimus flap transfer to restore ankle dorsiflexion following a traumatic defect of the lower leg: a case report. J Reconstr Microsurg 2014; 30 (04) 279-282
- 9 Narushima M, Yamasoba T, Iida T. et al. Pure skin perforator flaps: the anatomical vascularity of the superthin flap. Plast Reconstr Surg 2018; 142 (03) 351e-360e
- 10 Saint-Cyr M, Wong C, Schaverien M, Mojallal A, Rohrich RJ. The perforasome theory: vascular anatomy and clinical implications. Plast Reconstr Surg 2009; 124 (05) 1529-1544
- 11 Askouni EP, Topping A, Ball S, Hettiaratchy S, Nanchahal J, Jain A. Outcomes of anterolateral thigh free flap thinning using liposuction following lower limb trauma. J Plast Reconstr Aesthet Surg 2012; 65 (04) 474-481
- 12 Medina III MA, Salinas HM, Eberlin KR. et al. Modified free radial forearm fascia flap reconstruction of lower extremity and foot wounds: optimal contour and minimal donor-site morbidity. J Reconstr Microsurg 2014; 30 (08) 515-522
- 13 Wei F-C, Mardini S. Flaps and Reconstructive Surgery. 2nd ed. Edinburgh: Elsevier; 2017
- 14 Fan S, Zhang HQ, Li QX. et al. The use of a honeycomb technique combined with ultrasonic aspirators and indocyanine green fluorescence angiography for a superthin anterolateral thigh flap: a pilot study. Plast Reconstr Surg 2018; 141 (06) 902e-910e
- 15 Kim KN, Hong JP, Park CR, Yoon CS. Modification of the elevation plane and defatting technique to create a thin thoracodorsal artery perforator flap. J Reconstr Microsurg 2016; 32 (02) 142-146
- 16 Wei FC, Jain V, Celik N, Chen HC, Chuang DCC, Lin CH. Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 2002; 109 (07) 2219-2226 , discussion 2227–2230
- 17 Koshima I, Yamamoto T, Narushima M, Mihara M, Iida T. Perforator flaps and supermicrosurgery. Clin Plast Surg 2010; 37 (04) 683-689 , vii–iii
- 18 Goh TLH, Park SW, Cho JY, Choi JW, Hong JP. The search for the ideal thin skin flap: superficial circumflex iliac artery perforator flap--a review of 210 cases. Plast Reconstr Surg 2015; 135 (02) 592-601
- 19 Hong JP, Sun SH, Ben-Nakhi M. Modified superficial circumflex iliac artery perforator flap and supermicrosurgery technique for lower extremity reconstruction: a new approach for moderate-sized defects. Ann Plast Surg 2013; 71 (04) 380-383
- 20 Koshima I, Nanba Y, Tsutsui T. et al. Superficial circumflex iliac artery perforator flap for reconstruction of limb defects. Plast Reconstr Surg 2004; 113 (01) 233-240
- 21 Suh HSP, Jeong HH, Choi DH, Hong JPJP. Study of the medial superficial perforator of the superficial circumflex iliac artery perforator flap using computed tomographic angiography and surgical anatomy in 142 patients. Plast Reconstr Surg 2017; 139 (03) 738-748
- 22 Kiranantawat K, Yeo MSW, Imaizumi A. et al. The scrotal free flap: First successful clinical application of a free super-thin external pudendal artery (STEPA) flap for reconstruction of a foot defect. J Plast Reconstr Aesthet Surg 2018; 71 (02) 262-264
- 23 Colson P, Houot R, Gangolphe M. et al. [Use of thinned flaps (flap-grafts) in reparative hand surgery]. Ann Chir Plast 1967; 12 (04) 298-310
- 24 Thomas CV. Thin flaps. Plast Reconstr Surg 1980; 65 (06) 747-752
- 25 Patel KM, Shauly O, Gould DJ. Introducing the subdermal free flap: Preserving the ultrathin-free skin flap option in morbidly obese patients. J Surg Oncol 2018; 118 (03) 403-406
- 26 Driver VR, Fabbi M, Lavery LA, Gibbons G. The costs of diabetic foot: the economic case for the limb salvage team. J Vasc Surg 2010; 52 (3, Suppl): 17S-22S
- 27 Mayfield JA, Reiber GE, Maynard C, Czerniecki JM, Caps MT, Sangeorzan BJ. Survival following lower-limb amputation in a veteran population. J Rehabil Res Dev 2001; 38 (03) 341-345
- 28 Diamond S, Seth AK, Chattha AS, Iorio ML. Outcomes of subfascial, suprafascial, and super-thin anterolateral thigh flaps: tailoring thickness without added morbidity. J Reconstr Microsurg 2018; 34 (03) 176-184