Lower Extremity Reconstruction by Perforator Based Flap

Oh, Chang Hyun; Shim, Jeong Su; Park, Dae Hwan

Abstract

PURPOSE
Fasciocutaneous flap with random pattern flap has limitation in mobility and length-width ratio. This characteristic is more pronounced in lower extremity which has relatively poor vascularity. Perforator based flap in lower extremity reconstruction has various advantages as an axial flap, allowing abundant blood supply and widening of mobility range. So if it is not a case of wide defect, free flap can be replaced by perforator based flap.
METHODS
From April 2007 to March 2009, 18 cases of perforator flap were performed. 8 had defect in upper 1/3 of calf, 6 in middle 1/3, and 4 in lower 1/3. Among 10 cases in which island flap were used, 3 cases had transposition flap, 2 cases used advancement flap, 2 cases had propeller flap, and 1 case had rotation flap.
RESULTS
17 cases survived without flap necrosis. Partial flap necrosis occurred in 1 case, so secondary split thickness skin graft was done. Chronic wound with pseudomonas infection occurred in 1 case, but it was completely cured with conservative treatment.
CONCLUSION
Perforator based flap is useful in lower extremity reconstruction because of relative freedom in changing the size and thickness of the flap depending on the recipient site, good mobility, and abundant vascularity. And donor site morbidity can be minimized. Lower extremity reconstruction using perforator based flap is a good method because it can minimize the complication and obtain effective result.