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Propeller flap

Rei Ogawa, Shimpei Ono, Satoshi Akaishi, Teruyuki Dohi, Takeshi Iimura, Junichi Nakao
: It is difficult to completely resect huge anterior chest wall keloids and then close the wound directly. We report here our retrospective analysis of our case series of patients with such keloids who underwent reconstruction with internal mammary artery perforator (IMAP) pedicled propeller flaps and then received postoperative high-dose-rate superficial brachytherapy. METHODS: All consecutive patients with large/severe keloids on the anterior chest wall who underwent keloid resection followed by reconstruction with IMAP-pedicled propeller flaps and then high-dose-rate superficial brachytherapy in our academic hospital were identified...
September 2016: Plastic and Reconstructive Surgery. Global Open
Chad M Teven, Julie Mhlaba, Annemarie O'Connor, Lawrence J Gottlieb
The majority of surgical burn care involves the use of skin grafts. However, there are cases when flaps are required or provide superior outcomes both in the acute setting and for postburn reconstruction. Rarely discussed in the context of burn care, the perforator-based propeller flap is an important option to consider. We describe our experience with perforator-based propeller flaps in the acute and reconstructive phases of burn care. We reviewed demographics, indications, operative details, and outcomes for patients whose burn care included the use of a perforator-based propeller flap at our institution from May 2007 to April 2015...
October 7, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
So-Eun Han, Eun-Ji Kim, Hyun Hwan Sung, Jai-Kyong Pyon
BACKGROUND: Reconstruction of extensive penoscrotal defects is a surgical challenge. Resurfacing defects in highly complex three-dimensional structures and restoring their function are an essential part of the reconstruction of penoscrotal regions. OBJECTIVE: We describe a technique using internal pudendal artery perforator (IPAP) pedicled propeller flaps created from the gluteal fold. This could be a reliable surgical option that maintains a natural looking scrotal pouch with minimal donor site morbidity and optimal sexual activity...
October 12, 2016: European Urology
Semih Baghaki, Murat Diyarbakirlioglu, Ugur Sahin, Muge Anil Kucuksucu, Akif Turna, Bilgi Baca, Yağmur Aydın
Besides conventional flaps, intercostal artery perforator flaps have been reported to cover trunk defects. In this report the use of anterior intercostal artery perforator (AICAP) flap, lateral intercostal artery perforator (LICAP) flap and dorsal intercostal artery perforator (DICAP) flap for thoracic, abdominal, cervical, lumbar and sacral defects with larger dimensions and extended indications beyond the reported literature were reevaluated. Thirty-nine patients underwent surgery between August 2012 and August 2014...
October 5, 2016: Microsurgery
Anita T Mohan, Yoo Joon Sur, Lin Zhu, Mohamed Morsy, Peter S Wu, Steven L Moran, Samir Mardini, Michel Saint-Cyr
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Understand the history and physiology of perforator flaps. 2. Understand the concept of "free-style" perforator flaps and principles in design and harvest. 3. Understand the uses of perforator flaps in reconstruction and applications in new settings. 4. Understand new principles in single and multiple perforator flap harvest and adjunct techniques that can be used in perforator flaps. 5. Highlight pertinent anatomy and techniques for selected perforator flaps described...
October 2016: Plastic and Reconstructive Surgery
J Vitse, F Bekara, N Bertheuil, R Sinna, B Chaput, C Herlin
: Current data on upper extremity propeller flaps are poor and do not allow the assessment of the safety of this technique. A systematic literature review was conducted searching PubMed, EMBASE, and the Cochrane Library electronic databases, and the selection process was adapted from the preferred reporting items for systematic reviews and meta-analysis statement. The final analysis included ten relevant articles involving 117 flaps. The majority of flaps were used for the hand, distal wrist, and elbow...
September 26, 2016: Journal of Hand Surgery, European Volume
A K Kancharala, M K Philen
The versatility of fish to adapt to different swimming requirements is attributed to their complex muscular system. Fish modulate their fin stiffness and shape for maximized performance. In this paper, optimal chordwise stiffness profiles that maximize the propulsive performance have been predicted using theoretical studies. An experimental setup has been fabricated to measure the stiffness profiles of real fish caudal fins. Chordwise varying stiffness robotic fins fabricated using carbon fiber reinforced composites (CFRC) have been tested in the water tunnel to evaluate their performance over constant stiffness fins...
2016: Bioinspiration & Biomimetics
Obi Onyekwelu, Damir Kosutic
Wide local excision of skin cancer in the lumbar area is a challenge to reconstruct. We report on the successful use of a two perforators-based superior gluteal artery perforator propeller flap, for the reconstruction of a lumbar defect.
2016: Case Reports in Plastic Surgery & Hand Surgery
Pietro Giovanni di Summa, Clara Schaffer, Patrice Zaugg, Olivier Bauquis, Wassim Raffoul
We report the case of a 52-year-old man presenting an extensive lumbosacral necrosis after bilateral internal iliac arteries embolization following unstable pelvic fracture. Coverage of the defect was performed using two extended lumbar artery perforator flaps in a propeller fashion. Good functional and esthetic result was achieved at one-year follow-up.
2016: Case Reports in Plastic Surgery & Hand Surgery
Joo Myong Paik, Jai-Kyong Pyon
Background Freestyle propeller flaps have been widely used as a reconstructive option for both trunk and extremities. It offers the advantage of "like-with-like" reconstruction with an adjacent tissue with no dissection to the source vessels. However, there is the risk of vascular complications. In the present study, the authors investigated the incidence of vascular complications and their risk factors following freestyle propeller flap in the trunk and extremities. Methods The authors conducted a retrospective review of 50 patients who underwent soft tissue reconstruction of the trunk and the extremities with 55 freestyle propeller flaps from 2004 to 2015...
August 19, 2016: Journal of Reconstructive Microsurgery
Burhan Özalp, Mustafa Aydınol
BACKGROUND: Perforator-based propeller flaps provide adequate soft tissue coverage for leg reconstruction. The aim of this study was to assess the versatility and reliability of the use of propeller flaps for leg reconstruction in pediatric patients. METHOD: Seven male pediatric patients ranging in age from 2 to 13 years with a mean age of 6.7 underwent perforator-based propeller flap surgery over a four-year period. The defects resulted from burn injuries (n = 4) and traffic accidents (n = 3)...
October 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Brett Klaassen van Oorschot, Emily A Mistick, Bret W Tobalske
Birds morph their wings during a single wingbeat, across flight speeds and among flight modes. Such morphing may allow them to maximize aerodynamic performance, but this assumption remains largely untested. We tested the aerodynamic performance of swept and extended wing postures of 13 raptor species in three families (Accipitridae, Falconidae and Strigidae) using a propeller model to emulate mid-downstroke of flapping during take-off and a wind tunnel to emulate gliding. Based on previous research, we hypothesized that (1) during flapping, wing posture would not affect maximum ratios of vertical and horizontal force coefficients (CV:CH), and that (2) extended wings would have higher maximum CV:CH when gliding...
October 1, 2016: Journal of Experimental Biology
M Cerny, Y Harder, A Zimmermann, H-H Eckstein, H-G Machens, J-T Schantz, T L Schenck
INTRODUCTION: Vascular surgery through a groin incision may be associated with severe wound healing disorders in this sensitive area. There are many options to reconstruct the defect surgically. The choice of surgical reconstruction depends mainly on the individual status of vasculature, which is most often compromised in these patients. There are random pattern flaps, as well as perforator, pedicled flaps or microvascular flaps to choose from. AIM: We give an overview of plastic surgical solutions for groin defects, with a special focus on complex wounds after vascular surgical complications...
July 19, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Kostopoulos Epameinondas, Agiannidis Christos, Konofaos Petros, Dounavis Avraam, Papadopoulos Othon, Casoli Vincent
BACKGROUND: The proper digital arteries as any other axial vessel give rise to multiple cutaneous perforators either volar or dorsal along their course. Their identification is performed with Doppler flowmetry. The vasculo-cutano-tendino-osseous complex (VCTOC), which was described by the senior authors, was responsible for the vascularization of all digital anatomic structures (extensor apparatus, skin, periosteum). Their consistent appearance to well measured distances from the digital joints led the way to the present clinical study for highlighting this described anatomy in-vivo and demonstrating the predictability in digital artery perforator (DAP) flap harvest...
March 2016: Hand: Official Journal of the American Association for Hand Surgery
Gudjon Leifur Gunnarsson, Troels Tei, Jørn Bo Thomsen
Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap reconstruction throughout the body. The CDU was used to identify the largest and best-located perforator adjacent to the defect to target the reconstruction. The cutaneous or fasciocutaneous flaps were raised, mobilized, and designed according to the reconstructive needs as rotation, advancement, or turnover flaps...
October 2016: Annals of Plastic Surgery
Andrea Sisti, Carlo D'Aniello, Leonardo Fortezza, Juri Tassinari, Roberto Cuomo, Luca Grimaldi, Giuseppe Nisi
BACKGROUND/AIM: Since their introduction in 1991, propeller flaps are increasingly used as a surgical approach to loss of substance. The aim of this study was to evaluate the indications and to verify the outcomes and the complication rates using this reconstructing technique through a literature review. MATERIALS AND METHODS: A search on PubMed was performed using "propeller flap", "fasciocutaneous flap", "local flap" or "pedicled flap" as key words. We selected clinical studies using propeller flaps as a reconstructing technique...
July 2016: In Vivo
Utku C Dölen, Neil S Sachanandani, Thomas H Tung
The internal mammary artery perforator (IMAP) flap can be used as either loco-regional or free flap, and provides thin flexible coverage for defects of the chest wall and cervical regions. In this report, we present a bilateral mastectomy case in which the left mastectomy defect was closed with an IMAP propeller flap harvested from the right breast. Our patient with a history of left breast conservation therapy was diagnosed invasive ductal carcinoma in her left breast 14 years later. On physical examination, the patient's left breast displayed the stigmata of radiotherapy including dark discoloration and firmness to palpation, compared to contralateral pendulous breast...
September 2016: Microsurgery
Yahya Baltu, Hakan Uzun, Utku Can Dölen, Mustafa Özyurtlu
INTRODUCTION: Non-melanoma skin cancer is the most common type of skin cancer of the nasal dorsum and the medial canthal region, which is caused by chronic sun exposure. Limited adjacent tissue and the need for aesthetically pleasing result make the reconstruction of these regions very challenging. To overcome this challenge, we designed a perforator propeller flap based on the central artery. METHODS: Between January 2014 and November 2015, we covered the nasal or medial canthal defects of 22 patients with central artery perforator propeller flaps...
August 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Beniamino Brunetti, Stefania Tenna, Igor Poccia, Paolo Persichetti
BACKGROUND: Despite of the widespread use of 180-degree propeller flaps in the field of soft tissue reconstruction, less information are available in the current literature to standardize the use of propeller flaps with reduced degrees of rotation. The authors report their experience with propeller flaps with reduced rotational angles reviewing clinical applications and outcomes of the technique in a series of 40 consecutive reconstructions. PATIENTS AND METHODS: Forty elective defects of various etiologies located in different regions of the body (head and neck, trunk, buttocks and perineum, extremities) were reconstructed with less than 180 degrees rotated propeller flaps...
May 23, 2016: Annals of Plastic Surgery
Tetsuji Uemura, Hidekata Watanabe, Kazuyuki Masumoto, Mamoru Kikuchi, Yoshiyasu Satake, Tetsu Yanai, Yoshimi Harada, Yasuhiro Ishihara, Masato Yasuta
BACKGROUND: The aim of this study was to review the results of a cohort of patients based on our experience with a new technique for total lower eyelid reconstruction after a large defect caused by malignant tumor and trauma. A scapha cartilage graft with small skin on a vascularized propeller flap was used for 16 cases requiring lower eyelid reconstruction. METHODS: Patients were identified from a database, and a retrospective case note review was conducted. The scapha cartilage graft was sutured to the margin of the defect of the palpebral conjunctiva and tarsus...
April 2016: Plastic and Reconstructive Surgery. Global Open
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