Arch Plast Surg.  2013 Jan;40(1):44-50. 10.5999/aps.2013.40.1.44.

Indications, Outcomes, and Complications of Pedicled Propeller Perforator Flaps for Upper Body Defects: A Systematic Review

Affiliations
  • 1Plastic and Reconstructive Surgery Unit, Hospital of Pisa, Pisa, Italy.
  • 2Section of Plastic, Aesthetic and Reconstructive Surgery, General Hospital Linz, Linz, Austria.
  • 3Department of Plastic and Reconstructive Surgery, University of Tor Vergata, Rome, Italy.
  • 4Al-Babtain Hospital for Burn and Plastic Surgery, Kuwait City, Kuwait.
  • 5Department of Plastic and Reconstructive Surgery, Marche Polytechnic University Medical School, University Hospital, Ancona, Italy.
  • 6Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. zhangyixin6688@hotmail.com
  • 7Maxillofacial Surgery Unit, Hospital of Florence, Florence, Italy.

Abstract

BACKGROUND
The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects.
METHODS
A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis.
RESULTS
From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed.
CONCLUSIONS
Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.

Keyword

Pedicled flap; Review literature; Surgical flaps

MeSH Terms

Free Tissue Flaps
Humans
Lower Extremity
Perforator Flap
Pressure Ulcer
Retrospective Studies
Surgical Flaps
Ulcer
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