Resumo

MENDIETA-ESPINOSA, Mauricio; SIU-BERMUDEZ, Armando; ALTAMIRANO-FLORES, Roderick  e  CABRERA-MENDIETA, Rodrigo. Perforator propeller flaps for reconstruction of defects in middle and distal third of the limb. Cir. plást. iberolatinoam. [online]. 2017, vol.43, n.1, pp.87-96. ISSN 1989-2055.

Background and Objective: Local propeller flaps preserve the main vascular arteries of the lower extremity and muscle function, avoiding the need for a microsurgical anastomosis, and with the benefit of providing a like with like coverage. Our goal in this study is to demonstrate the safety and minimal complications of the local propeller flaps for lower extremity reconstruction. Methods. We present a series of 28 patients in which we performed local propeller flaps to restore small to medium defects of the lower limb. The flaps dimensions were between 12 to 156 cm², with an average of 48 cm². Flap rotation was performed in 180 degrees en 85% of the cases, 140 degrees in 11% and in 4% the flap was rotated 160 degrees. The propeller flaps were based in a single perforator, being the source the posterior tibial artery in 50%, anterior tibial artery in 39.3%, and peroneal artery in 10.7% of the cases. Results. Complications occurred in 14% of the propeller flaps performed. The complications were, 3 partial necrosis of less than 15% of the flap transposed, which were based on the posterior tibial artery, and 1 case of superficial epidermolysis in a propeller based flap of the anterior tibial artery. Complications of the patients occurred in both sex groups, however for the female group there were complications with a statistically significance of p 0.038. The donor site of the flap was closed primarily in 85.7% of the cases. Conclusions. In our opinion, the availability and safety of local propeller flaps justifies its use in those cases where microsurgical techniques are not an option for the reconstruction of the middle and distal extremity in small to medium defects.

Palavras-chave : Leg reconstruction; Lower limb reconstruction; Local perforator flaps; Propeller flaps.

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