VERSATILITY OF PERFORATOR-BASED PROPELLER FLAP IN RECONSTRUCTION OF VOLAR ASPECT OF DISTAL FOREARM, DISTAL LEG & ANKLE DEFECTS - A RETROSPECTIVE ANALYSIS

Background: The use of regional flaps based on perforator arteries is generating more interest in limb reconstruction surgery. The surgical approach allows for the restoration of soft tissue lesions using neighboring homologous tissues without the need for microvascular anastomosis. The aim of the study was to evaluate the clinical results of local perforator flaps in the treatment of complex lower limb and upper limb defects. Materials and Methods:Fourteen patients (six upper limb and eight lower limb defects) underwent reconstruction using perforator-based flaps which were studied retrospectively during a three-year period. Donor sites were examined thoroughly and flaps selection was done using a handheld manual Doppler mapping preoperatively, to locate the perforator vessels and their flow. Thereby, perforator-based propeller flaps were raised and used for defect coverage based on their maximum arc of rotation. Results:Postoperatively, all the flaps included in the study survived. Partial flap necrosis and venous congestion in the flap were reported in two patients following intervention. Donor site morbidity was minimal without any loss of function. Most of the patients were satisfied with the aesthetic outcome. Conclusion:Perforator flaps using hand held Doppler are the most yielding, simple and safe flaps for the Reconstructive Surgeons. The need for the complicated microsurgical procedures can be avoided with the use of such locoregional propeller flaps which providedbetter aesthetic results with minimal donor site morbidity.