• Rafael G Jakubietz, Danni F Jakubietz, Joerg G Gruenert, Karsten Schmidt, Rainer H Meffert, and Michael G Jakubietz.
• Department of Trauma, Plastic and Hand Surgery, Julius-Maximilian-University of Wuerzburg, Germany. Jakubietz_R@klinik.uni-wuerzburg.de
• Microsurgery. 2010 Nov 1;30(8):608-13.

IntroductionSoft tissue defects exposing the Achilles tendon are challenging. Local perforator flaps represent a valuable option gaining increasing popularity. Despite preoperative planning an adequate perforator cannot always be found intraoperatively. The free peroneal artery perforator flap can serve as a back-up option limiting the donor site morbidity to the same extremity without sacrificing major vessels or nerves.MethodsNine patients with soft tissue defects exposing the Achilles tendon were treated with local perforator flaps, seven were scheduled for 180° propeller flap coverage after Doppler-ultrasound examination. However, in two patients (22%) no adequate perforators were found intraoperatively. As the perforators for the free peroneal artery perforator flap were routinely mapped out, this flap was harvested for microsurgical reconstruction.ResultsOne patient with a 180° propeller flap developed a partial flap necrosis, another patient developed superficial epidermolysis, both requiring skingrafting. no complications were seen with free tissue transfer.ConclusionPedicled perforator flaps as propeller flaps add options to the armamentarium of microsurgeons. Despite thorough preoperative planning the surgeons must be prepared to perform a different method of reconstruction if inadequate vessels are encountered. To limit additional donor site morbidity, local options are preferred. The free peroneal artery perforator flap represents a good option as it matches the original tissue properties closely. The complication rate of propeller flaps in this series is tolerable. Propeller flaps should therefore be considered an alternative but not as a replacement of local fasciocutaneous flaps.Copyright © 2010 Wiley-Liss, Inc.

16 keywords...

hide…