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Scaglioni et al. Plast Aesthet Res 2019;6:27 Plastic and
DOI: 10.20517/2347-9264.2019.41 Aesthetic Research

Review Open Access

Perforator propeller flaps in lower limb
reconstruction: a literature review and case reports

Mario F. Scaglioni , Aljosa Macek 2
1
1 Department of Hand- and Plastic surgery, Luzerner Kantonsspital, Lucerne 6000, Switzerland.
2 Department of Surgery, Spital Männedorf, Männedorf 8708, Switzerland.

Correspondence to: Dr. Mario F. Scaglioni, Department of Hand- and Plastic Surgery, Luzerner Kantonsspital, Spitalstrasse 16, Lucerne
6000, Switzerland. E-mail: mario.scaglioni@gmail.com

How to cite this article: Scaglioni MF, Macek A. Perforator propeller flaps in lower limb reconstruction: a literature review and case reports.
Plast Aesthet Res 2019;6:27. http://dx.doi.org/10.20517/2347-9264.2019.41

Received: 18 Oct 2019 First Decision: 4 Nov 2019 Revised: 7 Nov 2019 Accepted: 14 Nov 2019 Published: 29 Nov 2019

Science Editor: Matthew L. Iorio Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract

Perforator-pedicled propeller flaps, which base their blood supply on isolated perforators, have been gaining popularity
among plastic surgeons over the past two decades. They have proven to be of great value in the reconstruction of soft
tissue defects in different areas of the body but are, thanks to their maximal mobility, mostly used in the reconstruction
of extremities. In this article, we focus on perforator-pedicled propeller flaps in lower limb reconstruction, where they
can be implemented in the coverage of primary as well as secondary soft tissue defects. Firstly, a brief literature review
on evolution of propeller flap use in lower extremity is provided. Moreover, we present our surgical technique including
the use of indocyanine green real-time angiography for reliable flap transfer. In addition, we report 3 cases of patients in
whom we used a local propeller flap for the closure of skin defects in different parts of the leg.

Keywords: Propeller flap, perforator flap, local flap, lower limb reconstruction, microsurgery

INTRODUCTION
Reconstruction of soft tissue defects in the lower limb is known to be difficult due to the lack of spare local
[1]
tissue in the immediate vicinity of such defects . Traditionally, these defects used to be covered, depending
[2-4]
on the location, size, and the underlying tissue, by split skin grafts, local transposition flaps, or free flaps .
All of the above have their obvious drawbacks and limitations; thus, over the past two decades, perforator
propeller flaps have been gaining popularity among reconstructive surgeons.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
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