Perforator flaps have become accepted as an excellent option for autologous breast reconstruction. The deep inferior epigastric perforator (DIEP) flap is the first-line option for perforator-based flaps in most patients due to the available tissue volume, skin quality, and secondary aesthetic benefits.1,2 However, variability in patient anatomy and body habitus create the need for reliable seco...

BACKGROUND Classical flaps for perinasal defect reconstruction, such as forehead or nasolabial flaps, have some disadvantages involving limitations of the arc of rotation and two stages of surgery. However, a perforator-based flap is more versatile and allows freedom in flap design. We introduced our experience with reconstruction using a facial artery perforator-based propeller flap on the per...

BACKGROUND The maximum weight of tissue that a single perforator can perfuse remains an important question in reconstructive microsurgery. An empirically based equation, known as the flap viability index (FVI), has been established to determine what weight of tissue will survive on one or more perforators. The equation is FVI = Sum d(n)^4/W, where d is the internal diameter of each perforator a...

Trauma, oncological resections and pressure sores can cause major soft tissue defects. The evolution of cutaneous, myocutaneous, and fasciocutaneous flaps currently makes possible the restoration of contour and, in many cases, function. This evolution was closely related to the increased understanding of the vascular anatomy of the skin and subcutis and has led to the development of perforator ...

SUMMARY The clinical value of distal ulnar or radial artery adipofascial perforator flaps is shown in a series of 30 patients with severe hand and wrist injuries and major soft tissue defects requiring coverage. There were 22 men and 8 women, aged 16-73 years. The defects were dorsal and/or palmar, with or without transpalmar or transcarpal amputation, or amputation of the thumb and/or the digi...

1 BACKGROUND Microsurgical training on rats before starting with clinical practice is a well-established routine. Animal model training is less widespread for perforator flaps, although these flaps represent a technical challenge. Unlike other flaps, they require specific technical skills that need to be adequately trained on a living model1: a cadaver is not enough because no bleeding, vessel ...

Introduction: Traditionally in reconstruction of lower limb soft tissue defects, muscle flaps have been the ‘Gold Standard’ for Gustillo Anderson Grade III B fracture involving upper and middle third defects. Lower third defects were usually reconstructed with free flaps. Evolution in flap surgery has enabled fasciocutaneous, adipofascial and superthin flaps to be harvested for the purpose of r...

Objective To describe the characteristics of the perforator vessel in the peroneal artery of the lower leg and to explore the use of perforator pedicle propeller flaps to repair soft tissue defects in the lower leg, heel and foot. Methods This retrospective study enrolled patients with soft tissue defects of the distal lower leg, heel and foot who underwent surgery using peroneal perforator-bas...

UNLABELLED One of the main steps in perforator flap surgery is to identify the dominant perforator. Using multidetector row computed tomography (MDCT) for the preoperative planning of deep inferior epigastric artery perforator (DIEAP) flap surgery, we identified a perforator with a large caliber, an excellent location in the middle abdominal region, and a totally extramuscular trajectory in a s...