Abstract
In the last years, propeller flaps have become an appealing option for coverage of a large range of defects. Besides having a more reliable vascular pedicle than traditional flap, propeller flaps allow for great freedom in design and for wide mobilization that extend the possibility of reconstructing difficult wounds with local tissues and minimal donor-site morbidity. They also allow one-stage reconstruction of defects that usually require multiple procedures. Harvesting of a propeller flap requires accurate patient selection, preoperative planning, and dissection technique. Complication rate can be kept low, provided that potential problems are prevented, promptly recognized, and adequately treated. This paper reviews current knowledge on propeller flaps. Definition, classification, and indications in the different body regions are discussed based on a review of the literature and on the authors' experience. Details about surgical technique are provided, together with tips to avoid and manage complications.
Highlights
IntroductionThe term “propeller flap” was first used in 1991 by Hyakusoku et al [1] to describe an adipocutaneous flap based on a central subcutaneous pedicle, with a shape resembling a propeller that was rotated 90 degrees
The term “propeller flap” was first used in 1991 by Hyakusoku et al [1] to describe an adipocutaneous flap based on a central subcutaneous pedicle, with a shape resembling a propeller that was rotated 90 degrees.In 2006, combining the concept of propeller flaps and perforator based flaps, Hallock [2] reported a fasciocutaneous flap that was similar in shape to the one described by Hyakusoku but was based on a skeletonized perforating vessel and was rotated 180 degrees on an eccentric pivot point
Teo [3] gave the greatest contribution to the surgical technique and the application of the perforator propeller flap
Summary
The term “propeller flap” was first used in 1991 by Hyakusoku et al [1] to describe an adipocutaneous flap based on a central subcutaneous pedicle, with a shape resembling a propeller that was rotated 90 degrees. The introduction of the propeller flaps gained great popularity; these flaps have been increasingly used for reconstruction of soft tissue defects of different parts of the body, and surgical technique has been refined and well described by several authors [4,5,6,7,8,9]. Recommendations for judicious planning of perforator propeller flaps in different body areas are provided; technical refinements and tips on how to avoid common mistakes are discussed
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