The clinical application of free-style cutaneous perforator flaps

Abstract

Perforator flaps have become increasingly popular in reconstructive surgery. In theory, a flap can be based on any identified perforator, whether free or pedicled, based on the perforasome concept. In this study, we report our initial experience with free-style perforator flaps for reconstruction of complex soft tissue wounds. We present two cases of free-style cutaneous perforator flaps; one pedicled free-style perforator flap was designed and elevated adjacent to a complex hip wound and another free-style free perforator flap was elevated in the thigh based on a perforator identified within the flap territory, but no dominant perforator was present for a free anterolateral thigh (ALT) perforator flap. In this case, a free ALT flap was converted to a free-style free perforator flap for the anterior neck reconstruction. Two free-style perforator flaps, one pedicled and one free, were successfully performed to reconstruct complex wounds of the hip and anterior neck. During more than 12 months of follow-up, both reconstructions have healed adequately with optimal contour in the reconstructed areas. This series demonstrates some of the clinical applications available using both free and pedicled freestyle perforator flaps. These free-style flaps can be used successfully with good esthetic and functional results at various regions of the body if there is a detectable perforator that can be based on as a perforator flap.