Clinical application of special forms of perforator flaps in orthopedic trauma / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical results,indications and precautions of a variety of special forms of the perforator flap for reconstructing limb soft-tissue defect.Methods From January 2008 to December 2013,480 cases suffering from limb soft-tissue defect were treated with special forms of the perforator flap.Types of special forms of the perforator flap included flow-through perforator flaps,micro-dissected perforator flaps,conjointed perforator flaps,polyfoliate perforator flaps and chimeric perforator flaps.Derivative types combined two or three technologies used in basic types.Results Venous crisis of the flap was shown in 10 cases.Through a second surgical exploration,5 cases were diagnosed with anastomotic thrombosis,2 with vascular torsion and 3 with hematoma.After appropriate treatments,flaps survived in 4 cases,but partial necrosis occurred in 6 cases.Twelve cases were found to have infection,which led to arterial crisis followed by total flap necrosis in one of them at postoperative day 5.Other flaps survived and wounds healed by first intention.Donor sites were repaired by skin flap transfer in 8 cases,skin grafting in 3 cases and direct suture in the rest cases.Conclusion Special forms of the perforator flap are optimal for repair of soft-tissue defect of extremities.