Predictors of the surgical outcome of propeller perforator flap reconstruction, focusing on the effective safe distance between the perforator and the wound edge

Abstract Background Soft tissue defects in the distal third of leg and malleolus are difficult to cover often require free transfer, even for small-sized defects. Propeller flaps were designed as an alternative but reportedly associated with high complication rates. The aim our study was assess institutional experience propeller flap technique predict its outcome lower-limb reconstruction. Methods All patients who had undergone reconstruction a defect between 2013 2018 included. Demographic, clinical, follow-up data analyzed. Results Complications occurred 17 82 (20.7%), comprising 11 cases partial necrosis six total necrosis. There no significant differences age, sex, body mass index smoking, diabetes mellitus, soft sites groups versus without ( p > 0.05). In univariate analysis, there also these two length width fascial pedicle, ratio Interestingly, distance perforator, shortest from perforator location, rotation angle < multivariable logistic regression analysis odds ratios (ORs) 95% confidence intervals (95% CIs), location risk factor complications = 0.000; OR 0.806). Receiver operating characteristic curve showed that when wound less than 3.5 cm, rate markedly increased (AUC 76.1); this suggests effective safe flap–wound cm. Conclusions reliable option carefully selected traumatic lower limb malleolus. We found cm wound.