• B Chaput, S Gandolfi, C Ho Quoc, J-P Chavoin, I Garrido, and J-L Grolleau.
• Plastic and reconstructive surgery unit, faculty of medicine, university Toulouse Rangueil, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse, France. Electronic address: Benoitchaput31@gmail.com.
• Ann Chir Plast Esthet. 2014 Feb 1; 59 (1): 65-9.

AbstractIn recent years, perforator flaps have become an indispensable tool for the reconstruction process. Most recently, "propeller" perforator flaps allow each perforator vessels to become a flap donor site. Once the perforator of interest is identified by acoustic Doppler, the cutaneous or fascio-cutaneous island is designed and then customized according to the principle of "perforasome". So, the flap can be rotated such a propeller, up to 180°. Ideally the donor site is self-closing, otherwise it can be grafted at the same time. Through a skin necrosis secondary to a contrast medium extravasation of the cubital fossa in a 47-year-old man, we describe the use of propeller perforator flap based on a perforator of the radial collateral artery (RCAP). The perforator was identified preoperatively by acoustic Doppler then the flap was adapted bespoke to cover the loss of substance. Ultimately, the result was very satisfying. Well experienced for lower-extremity reconstruction, perforator-based propeller flap are still few reported for upper limb. It is likely that in the future, propeller flap supersede in many indication not only free flaps and locoregional flaps but also, leaving no room for uncertainties of the vascular network, the classic random flaps.Copyright © 2013 Elsevier Masson SAS. All rights reserved.

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