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Purpose: Fasciocutaneous flap with random pattern flap has limitation in mobility and length - width ratio. This characteristic is more pronounced in lower extremity which has relatively poor vascularity. Perforator based flap in lower extremity reconstruction has various advantages as a axial flap, allowing abundant blood supply and widening of mobility range. So if it is not a case of wide defect, free flap can be replaced by perforator based flap.
Methods: From April 2007 to March 2009, 18 cases of perforator flap were performed. 8 had defect in upper 1/3 of calf, 6 in middle 1/3, and 4 in lower 1/3. In 10 cases island flap were used, 3 case had transposition flap, 2 cases used advancement flap, 2 case had propeller flap and 1 case had rotation flap.
Results: 17 cases survived without flap necrosis. Partial flap necrosis occurred in 1 case, so secondary split thickness skin graft was done. Chronic wound with pseudomonas infection occurred in 1 case, but it was completely cured with conservative treatment.
Conclusion: Perforator based flap is useful in lower extremity reconstruction because of relative freedom in changing the size and thickness of the flap depending on the recipient site, good mobility, and abundant vascularity. And donor site morbidity can be minimized. Lower extremity reconstruction using perforator based flap is a good method because it can minimize the complication and obtain effective result.번호 | 참고문헌 | 국회도서관 소장유무 |
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1 | The Posterior Tibial Perforator Adipofascial Flap for Reconstruction of Lower Leg | 소장 |
2 | Lower Extremity Reconstruction of Soft Tissue Defects with Perforator Island Flap | 소장 |
3 | Ponten B: The fasciocutaneous flap: its use in soft tissue defects of the lower leg. Br J Plast Surg 34: 215, 1981 | 미소장 |
4 | Taylor GI, Palmer JH: The vascular territories (angiosome) of the body: experimental study and clinical applications. Br J Plast Surg 40: 113, 1987 | 미소장 |
5 | A new concept of vascular supply to the skin and classification of skin flaps according to their vascularization. ![]() |
미소장 |
6 | Jeon BJ, Lim SY, Hyon WS, Bang SI, Oh KS, Mun GH: Anterolateral thigh flap: our experiences in head and neck reconstruction. J Korean Soc Plast Reconstr Surg 33: 276, 2006 | 미소장 |
7 | Our experience in lower limb reconstruction with perforator flaps. ![]() |
미소장 |
8 | Lower extremity muscle perforator flaps for lower extremity reconstruction. ![]() |
미소장 |
9 | Emsen IM: An alternative and new approach to free flap in treatment of calcaneal region and lower third of the lower extremity reconstruction: reverse flow posterior tibial fasciocutaneous skin island flaps. J Trauma 64: 780, 2008 | 미소장 |
10 | Schaverien M, Saint-Cyr M: Perforators of the lower leg: analysis of perforator locations and clinical application for pedicled perforator flaps. Plast Reconstr Surg 122: 161, 2008 | 미소장 |
11 | Freestyle perforator-based V-Y advancement flap for reconstruction of soft tissue defects at various anatomic regions. ![]() |
미소장 |
12 | The 180-Degree Perforator-Based Propeller Flap for Soft Tissue Coverage of the Distal, Lower Extremity ![]() |
미소장 |
13 | Moscatiello F, Masia J, Carrera A, Clavero JA, Larranaga JR, Pons G: The 'propeller' distal anteromedial thigh perforator flap. Anatomic study and clinical applications. Ann Plast Surg 60: 1323, 2007 | 미소장 |
14 | Various Perforationg Artery Pedicled Flaps ![]() |
미소장 |
15 | Perforator-based Fasciocutaneous Rotation Flap | 소장 |
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