Anterolateral thigh flap harvest based on a single musculocutaneous perforator. The aims of this atlas are to introduce the clinical applications of perforator flaps in plastic surgery and skin replacement. Background autologous breast reconstruction after mastectomy in. The current study introduces and demonstrates our experience of using a sequential thoracoacromial artery perforator taap flap to repair the sternocleidomastoid scm flap donor site in this context. A combination of bovie cauterie and bipolar cauterie are used for perforator dissection and the lateral skin paddle incision is left intact until the entire pedicle is harvested. Estimation of diep flap weight for breast reconstruction. The ipup flap technique takes advantage of the perforator principles. The deep defects with the exposure of tendon and bone were repaired by paraumbilical perforator flap finally. Figure 6 from direct and indirect perforator flaps. Advances in autologous breast reconstruction continue to mount and have been fueled most substantially with refinement of perforator flap techniques. A sequential thoracoacromial artery perforator flap for. Purchase preexpanded perforator flaps, an issue of clinics in plastic surgery, volume 441 1st edition. It was found that these flaps were done for in all age groups from pediatric to adult in both sexes figure 4.
Importance of lateral row perforator vessels in deep inferior epigastric perforator flap harvesting. To ilustrate the imaging protocol and anatomic findings variations of dieap. Request pdf paraumbilical perforator flap for soft tissue reconstruction of the forearm numerous flaps exist for coverage of injuries to the upper extremity, ranging from local, to regional. Perforator flaps can be used as local perforator flaps or as perforator free flaps. Note preservation of motor branches from the femoral nerve.
Pdf paraumbilical perforatorbased pedicled abdominal. Study of paraumbilical perforators in a normal population group. A good choice for the repair of the deep soft tissue defects in the hand and forearm find, read and cite all. Koshima i, moriguchi t, soeda s, tanaka h, umeda n.
A total of 40 paraumbilical perforator based abdominal flaps were done. It was found that the paraumbilical perforator based abdominal flaps can be harvested in any zone, in any direction. T1 oblique pedicled paraumbilical perforator based flap for reconstruction of complex proximal and midforearm defects. A brief history of perforator flaps hallock journal of. Periumbilical perforator sparing components separation. The paraumbilical perforator flap has reliable blood supply, good texture, sufficient area, and is. Munhoz am, ishida lh, sturtz gp, cunha ms, montag e, saito fl, gemperli r, ferreira mc. Forearm and hand, paraumbilical flap, vascular pedicle. The deep inferior epigastric perforator flap alone was referred to by many names, including paraumbilical perforator flap, paraumbilical perforator based flap, deep inferior epigastric perforator flap, deep inferior epigastric artery perforator flap, inferior epigastric artery skin flap. Paraumbilical perforator flap for soft tissue reconstruction of the. Paraumbilical perforator flap without deep inferior epigastr. Paraumbilical perforator based pedicled abdominal flap for extensive softtissue deficiencies of the forearm and hand.
The arterial and venous anatomies of the deep inferior. The pedicled inferior paraumbilical perforator ipup flap for a volar. After a brief introduction of the concept and surgical rationale of perforator flaps, the book presents 24 different flaps from donor sites including upper limb, lower limb and the trunk. Paraumbilical perforator flap for soft tissue reconstruction of the forearm. Evaluation paraumbilical flap for coverage of forearm and hand. These flaps are suitable for defects in the head and neck region, because simultaneous flap elevation is possible at the time of tumor resection. Figure 1 abdominal flap pinch test at three paraumbilical sites. To demonstrate usefulness of ct angiography cta in preoperative planning of deep inferior epigastric artery perforator dieap flaps. Oblique pedicled paraumbilical perforatorbased flap for reconstruction of complex proximal and midforearm defects. The paraumbilical perforator flap has many advantages, such as reliable blood supply, good texture, sufficient area, and convenient transfer 36. The pedicled inferior paraumbilical perforator ipup.
Whereas i have become the epitome of history, it is no wonder i am often called upon to not only reiterate the obvious. The territory of the thin flaps is within 10cm around the perforator. The authors present a successful novel reconstructive solution. Paraumbilical perforator flap for soft tissue reconstruction of. The paraumbilical perforator flap is the first and the most famous perforator flap. The paraumbilical perforator pup flap for upper extremity coverage can offer the benefits and versatility of pedicled and free flaps while avoiding some of the donorsite morbidity and risks of free tissue transfer. Septocutaneous gluteal artery perforator scgap flap for. After admission, the patients underwent the debridement, vacuum suction, and skin graft to repair partial wound. Pdf oblique pedicled paraumbilical perforatorbased flap. Pdf on jan 1, 2017, jin wang and others published paraumbilical perforator flap. Limb salvage using combined linking perforator free flaps. In 1983, taylor and others first reported the use of the paraumbilical perforator flap 2, which is a type of axial vascular flap supplied by the perforator vessels beside the umbilicus.
Figure 4 to increase exposure, retract the rf muscle medially to expose the descending branch of the lcfa running from medial to. The aims of this technique are to optimize both esthetic and functional outcomes and to reduce postoperative complications for patients. Incise the medial edge of the flap down through the deep fascia to the muscle, usually rf or vastus medialis. Oblique pedicled paraumbilical perforatorbased flap for. Cheah1 1department of hand and reconstructive microsurgery, university orthopaedic and hand reconstructive microsurgery cluster, national university health system, singapore, singapore published online. Case report successful limb salvage in a case of pretibial. The impact of cta in preoperative planning of deep. Perforator flap surgery was described as extravagant and exceptional in those days but it has now become the mainstream reconstructive technique for restoring defects throughout the body. The soleus perforator flap basically is a true perforator flap with a short pedicle, consisting of septo or septomyocutaneous perforators on which anastomoses are performed. Within the first years of development of perforator flaps confusion arose about the nomen.
Presented as the keynote opening speech at the 7th china summit forum for perforator flap, changsha, september 8, 2017. The pedicled inferior paraumbilical perforator ipup flap for a volar wrist defect. The perforator flap is an increasingly common approach in the field of flap transplantation, the most commonly used perforator flap in clinical research and application, diep is widely used for breast reconstruction, reconstruction and repair of limbs and related sites, with good efficacy. Paraumbilical perforatorbased flaps are suitable for young females and elderly patients. Preexpanded perforator flaps, an issue of clinics in. Preexpanded paraumbilical perforator flap clinics in plastic. The tie between perforator flaps and skin flaps as well as perforator flaps and musculocutaneous flaps is explained. Left right paraumbilical flap thickness, center left paraumbilical flap thickness, and right inferior paraumbilical flap thickness. The advantages of the paraumbilical perforator flap are as follows. A good choice for the repair of the deep soft tissue defects in the hand. Study of paraumbilical perforators in a normal population. The paraumbilical perforator flap is a type of axial vascular flap in which perforator vessels beside the umbilicus are used as nutritional vessels. The paraumbilical perforator flap, the deep inferior epigastric artery flap diep flap, the gluteal artery perforator hap gap flap and various perforator flaps and perforator based flaps are described in combination with the. What started as a small meeting among friends, has grown into a major international forum where colleagues share their new ideas in the field of perforator.
Yang wg, chiang yc, wei fc, feng gm, chen kt 2006 thin anterolateral thigh perforator flap using a modified perforator microdissection technique and its clinical application for foot resurfacing. Reconstruction of extensive upper extremity defects using. Gradually elevate the flap subfascially from medial to lateral until skin perforator vessels are visualized. With the report of freestyle free flaps by wei and mardini 20, a new gate has been opened for reconstruction of defects using tissues harvested from anywhere of the body provided that tissue encountered is the most suitable and similar and is supplied. Preexpansion increases the flap dimension and reduces the flap thickness and donor site morbidities, making the paraumbilical perforator flap a more effective option for upper extremity reconstruction. Preexpanded perforator flaps, an issue of clinics in plastic surgery volume 441 the clinics.
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