Datli Asli, Suh HyunSuk, Kim Young Chul, Choi Doon Hoon, Hong Joon Pio Jp
Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Plast Reconstr Surg Glob Open. 2017 Mar 16;5(3):e1249. doi: 10.1097/GOX.0000000000001249. eCollection 2017 Mar.
The reconstruction of the posterior trunk, especially with large dead spaces, remains challenging. Regional muscle flaps may lack adequate volume and reach. The purpose of this report was to evaluate the efficacy of deepithelialized free-style perforator-based propeller flaps to obliterate defects with large dead space.
A total of 7 patients with defects on the posterior trunk with large dead spaces were evaluated. After complete debridement or resection, all flaps were designed on a single perforator adjacent to the defect, deepithelialized, and then rotated in a propeller fashion. Flaps were further modified in some cases such as folding the flap after deepithelialization to increase bulk and to obliterate the dead space.
The flap dimension ranged from 10 × 5 × 1 to 15 × 8 × 2.5 cm based on a single perforator. The rotation arch of the flap ranged from 90 to 180 degrees. Uneventful healing was noted in all cases. One case showed latent redness and swelling at 7 months after falling down, which resolved with medication. During the average follow-up of 28 months, there were no other flap and donor site complications.
The deepithelialized propeller flap can be used efficiently to obliterate dead spaces in the posterior trunk and retains advantages such as having a good vascular supply, adequate bulk, sufficient reach without tension, and minimal donor site morbidity.
后躯干的重建，尤其是存在大的死腔时，仍然具有挑战性。局部肌皮瓣可能缺乏足够的体积和覆盖范围。本报告的目的是评估去上皮化的基于游离式穿支的推进皮瓣消除大死腔缺损的疗效。
共评估了7例后躯干存在大死腔缺损的患者。在彻底清创或切除后，所有皮瓣均基于缺损附近的单一穿支进行设计，去上皮化，然后以推进方式旋转。在某些情况下，皮瓣会进一步改良，例如去上皮化后折叠皮瓣以增加体积并消除死腔。
基于单一穿支设计的皮瓣尺寸范围为10×5×1至15×8×2.5厘米。皮瓣的旋转弧度范围为90至180度。所有病例均愈合顺利。1例在跌倒后7个月出现潜在的红肿，经药物治疗后消退。在平均28个月的随访期间，未出现其他皮瓣及供区并发症。
去上皮化推进皮瓣可有效用于消除后躯干的死腔，并保留血管供应良好、体积足够、覆盖范围充足且无张力、供区并发症最少等优点。
