Propeller Perforator Flaps in Hand Reconstruction: The effect of blood vessel twisting

Authors

  • Filip Ardelean
  • Maximilian Muntean
  • Dinu Dumitrascu
  • Stefan Strilciuc
  • Alexandru Valentin Georgescu

DOI:

https://doi.org/10.15386/cjmed-448

Keywords:

perforator flaps, hand reconstruction, perforator

Abstract

Background and aims. Perforator flaps increasingly find acceptance and use in hand reconstructive surgery. A propeller flap is an island flap that moves from one orientation to another by rotating around its vascular pedicle. It is now possible to design propeller flaps based on a single perforator, so-called "perforator-based propeller flaps," but they are more prone to vascular impairment when twisted more than 90°.

Methods. We present a prospective study conducted in the Plastic and Reconstructive Surgery Department of the Rehabilitation Hospital over 17 months. All perforator-based propeller flaps that were used for hand reconstruction were analyzed. The parameters studied included the size and location of the defect, the size and shape of the flap, the perforator (length and location) that was used, the degree of twisting of the perforator, the degree of perforator dissection,  the management of the donor site, and flap survival area.

Results. In this study we investigated the circulatory impairment induced by twisting of the pedicle on a true perforator flap. All flaps survived completely with the exception of partial skin necrosis in few cases. Some of these cases required debridement and skin grafting.

Conclusions. Perforator-based propeller flaps provide a reliable option for covering small- to medium-size hand complex tissue defects. They have the advantages of using similar tissues in reconstruction, not damaging another area, they do not require main vessels sacrifice, and the donor site can be generally directly closed.

Author Biographies

Filip Ardelean, Clinic of Plastic and Reconstructive Microsurgery University of Medicine Iuliu Hatieganu

Plastic and Reconstructive Microsurgery

Maximilian Muntean, Clinic of Plastic and Reconstructive Microsurgery

Plastic and Reconstructive Microsurgery

Dinu Dumitrascu, University of Medicine Iuliu Hatieganu

Anatomy

Stefan Strilciuc, Babes-Bolyai University, Cluj-Napoca

Center for Health Policy and Public Health

Alexandru Valentin Georgescu, Clinic of Plastic and Reconstructive Microsurgery University of Medicine Iuliu Hatieganu

Plastic and Reconstructive Microsurgery

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Published

2015-07-22

How to Cite

1.
Ardelean F, Muntean M, Dumitrascu D, Strilciuc S, Georgescu AV. Propeller Perforator Flaps in Hand Reconstruction: The effect of blood vessel twisting. Med Pharm Rep [Internet]. 2015 Jul. 22 [cited 2025 Oct. 5];88(3):343-7. Available from: https://medpharmareports.com/index.php/mpr/article/view/448

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Section

Original Research