El-Gammal, T., Hasan, Y., Raief, T., Elyounsi, M., Adel, M. (2022). Role of Perforator Flaps in Leg and Foot Reconstruction. The Egyptian Journal of Hospital Medicine, 89(2), 6091-6100. doi: 10.21608/ejhm.2022.268097
Tarek Abdella El-Gammal; youssef Hasan; Tarek Raief; Mohamed Elyounsi; Mohamed Adel. "Role of Perforator Flaps in Leg and Foot Reconstruction". The Egyptian Journal of Hospital Medicine, 89, 2, 2022, 6091-6100. doi: 10.21608/ejhm.2022.268097
El-Gammal, T., Hasan, Y., Raief, T., Elyounsi, M., Adel, M. (2022). 'Role of Perforator Flaps in Leg and Foot Reconstruction', The Egyptian Journal of Hospital Medicine, 89(2), pp. 6091-6100. doi: 10.21608/ejhm.2022.268097
El-Gammal, T., Hasan, Y., Raief, T., Elyounsi, M., Adel, M. Role of Perforator Flaps in Leg and Foot Reconstruction. The Egyptian Journal of Hospital Medicine, 2022; 89(2): 6091-6100. doi: 10.21608/ejhm.2022.268097
Role of Perforator Flaps in Leg and Foot Reconstruction
Plastic Surgery-Faculty of Medicine-Assiut University
Abstract
Background: Lower extremity wounds have been always a challenge for reconstructive surgeons. Free perforator flaps are considered to be the best option for this problem but require the complexity of microsurgery. So, pedicled perforator flaps have emerged as an alternative option. The aim of the present study is the assessment of efficacy of perforator flaps (either free flaps or pedicled flaps) regarding the coverage of traumatic soft tissue defects on the leg and foot. Patients and methods: A prospective study was conducted upon 40 patients with traumatic soft tissue defects in the leg and foot. The free flaps used were anterolateral thigh flap (ALT) and medial sural artery perforator flap (MSAP). In pedicled perforator flaps group, 10 cases were designed as propeller flaps, while the other 10 flaps were designed as perforator plus flaps. Results: Free flaps were mainly used for large sized defects; one case of partial flap loss and one case of complete flap necrosis. MSAP flap was the first option for coverage of large sized defects on foot and ankle as it's a thin and pliable flap, while ALT flap was used for coverage of larger defects on the leg. Pedicled perforator flaps were used mainly for small to medium-sized defects especially in the lower third of the leg; we had 3 cases of flap loss in propeller flap design while we had no cases of flap loss in perforator plus flap. Conclusion: Perforator flaps have become a reasonable solution for soft tissue defects of the lower extremity. Careful assessment of the dimensions, location, patient comorbidities, availability of surrounding soft tissue and presence of adequate perforators are mandatory for proper perforator flap selection.
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