Use of Propeller Flap in the Coverage of Soft-Tissue Injury in the Lower Limb^[*]

Abstract

Objective To evaluate the use of a propeller flap to cover soft-tissue injuries in the lower limb.

Materials and Methods A retrospective study, with review of medical records, and a convenience sample of 14 patients operated between July 2018 and June 2019. The following clinical aspects were evaluated: sex; age group; type of injury; cause of the injury; initial diagnosis; affected location; techniques for incision and identification; surgical planning; flap design; postoperative period; result of the propeller flap; and complications.

Results The sample was composed of male patients (100%), with a mean age of 36.4 years, and 92.7% of the injuries resulted from motorcycle accidents, mostly on the right side (71.4%). The surgical planning of the propeller flap followed the same procedure in all cases. Immediate postsurgical complications were present in 35.7% of the cases, and they included excessive bleeding (14.3%), partial necrosis (14.3%), and flap dehiscence (7.1%). In total, 13 patients had excellent coverage, and only 1 had flap loss.

Conclusion The propeller-flap technique to cover lesions in the lower limb proved to be a good alternative in most cases evaluated, with a good surgical result, although complications were observed in some cases.

Keywords

soft tissue injuries - perforator flap - lower extremity

^* Work developed at the Department of Orthopedics and Traumatology, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brazil.

Publication History

Received: 11 December 2019

Accepted: 15 April 2020

Article published online:
25 September 2020

• Referências

• 1 Rodrigues BL, Portela AR, Pastore Neto M, Drumond AF. Lesão grave de partes moles decorrente de acidente motociclístico. Rev Med Minas Gerais 2013; 23 (04) 536-539
• 2 Aquino Y. Acidentes no trânsito deixaram mais de 1,6 milhão feridos em 10 anos: seis de cada dez casos graves são de pessoas entre 15 e 39 anos. Empresa Brasil de Comunicação, Brasília, 23 mai 2019, Saúde. Disponível em: [Acesso em: 23 jul 2019] http://agenciabrasil.ebc.com.br/saude/noticia/2019-05/acidentes-no-transito-deixaram-mais-de-16-milhao-feridos-em-10-anos
• 3 Andrade SM, Jorge MH. Características das vítimas por acidentes de transporte terrestre em município da Região Sul do Brasil. Rev Saude Publica 2000; 34 (02) 149-156
• 4 Koizumi MS. Padrão das lesões nas vítimas de acidentes de motocicleta. Rev Saude Publica 1992; 26 (05) 306-315
• 5 Saad FT, Almeida KG, Almeida PY. et al. Reconstrução de dorso do pé com retalho supramaleolar lateral de fluxo reverso em menor de 4 anos de idade. Rev Bras Cir Plást 2015; 30 (02) 324-332
• 6 Chang AJ, Milcheski DA, Nakamoto H, Tuma Junior P, Lobato R, Ferreira MC. Condutas em traumas complexos de partes moles de membros inferiores no HCFMUSP. Rev Bras Cir Plást 2013; 28 (3, Suppl) 1-103
• 7 Macedo JL, Rosa SC, Silva AA, Filho Neto AVR, Ruguê PH, Scartazzini C. Versatilidade do uso do retalho do músculo gastrocnêmio medial na reconstrução de lesões de partes moles de membros inferiores. Rev Bras Cir Plást 2016; 31 (04) 527-533
• 8 Teixeira Neto N, Chi A, Paggiaro AO, Ferreira MC. Tratamento cirúrgico das feridas complexas. Rev Med (São Paulo) 2010; 89 (3/4): 147-151
• 9 Rezende MR, Rabelo NT, Benabou JE. et al. Cobertura do terço distal da perna com retalhos de perfurantes pediculados. Acta Ortop Bras 2008; 16 (04) 223-229
• 10 Sisti A, D'Aniello C, Fortezza L. et al. Propeller Flaps: A Literature Review. In Vivo 2016; 30 (04) 351-373
• 11 DETRAN. Departamento estadual de trânsito. Estatísticas. Disponível em: [Acesso em: 14 jul 2019] http://inside.detran.go.gov.br/acidente/index.htm
• 12 Sado JM, Morais FD, Viana FP. Caracterização das vítimas por acidentes motociclísticos internados no hospital de urgências de Goiânia. Rev Movimenta 2009; 2 (02) 49-53
• 13 Shen L, Liu Y, Zhang C. et al. Peroneal perforator pedicle propeller flap for lower leg soft tissue defect reconstruction: Clinical applications and treatment of venous congestion. J Int Med Res 2017; 45 (03) 1074-1089
• 14 Mendieta M, Cabrera R, Siu A, Altamirano R, Gutierrez S. Perforator Propeller Flaps for the Coverage of Middle and Distal Leg Soft-tissue Defects. Plast Reconstr Surg Glob Open 2018; 6 (05) e1759
• 15 Debieux P, Chertman C, Mansur NS, Dobashi E, Fernandes HJ. Lesões do aparelho locomotor nos acidentes com motocicleta. Acta Ortop Bras 2010; 18 (06) 353-356
• 16 Sasidaran R, Zain MA, Basiron NH, Ajik S. Propeller flaps in lower limb reconstruction: case series. Anaplastology 2013; 3 (01) 1-4
• 17 Bajantri B, Bharathi RR, Sabapathy SR. Wound coverage considerations for defects of the lower third of the leg. Indian J Plast Surg 2012; 45 (02) 283-290
• 18 D'Arpa S, Toia F, Pirrello R, Moschella F, Cordova A. Propeller flaps: a review of indications, technique, and results. BioMed Res Int 2014; 2014: 986829
• 19 Nelson JA, Fischer JP, Brazio PS, Kovach SJ, Rosson GD, Rad AN. A review of propeller flaps for distal lower extremity soft tissue reconstruction: Is flap loss too high?. Microsurgery 2013; 33 (07) 578-586