Pignatti Marco, Ogawa Rei, Mateev Musa, Georgescu Alexandru V, Balakrishnan Govindasamy, Ono Shimpei, Cubison Tania, Pinto Valentina, D'Arpa Salvatore, Koshima Isao, Hyakusoku Hiko, Hallock Geoffrey G
Department of Plastic Surgery, Policlinico di Sant'Orsola - DIMES, University of Bologna, Bologna, Italy.
Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan.
Semin Plast Surg. 2020 Aug;34(3):139-144. doi: 10.1055/s-0040-1715158. Epub 2020 Sep 22.
The term was introduced for the first time by Hyakusoku to define an island flap, based on a subcutaneous pedicle hub, that was rotated 90 degrees to correct scar contractures due to burns. With the popularization of perforator flaps, the propeller movement was applied for the first time to a skin island vascularized only by an isolated perforator, and the terms and were used together. Thereafter, the surgical technique of propeller flaps evolved and new applications developed. With the "Tokyo consensus," we proposed a definition and a classification schema for propeller flaps. A propeller flap was defined as an "island flap that reaches the recipient site through an axial rotation." The classification included the SPP (SPP) flap, the perforator pedicled propeller (PPP) flap, and the supercharged PPP (SCP) flap. A recent update added a new category, the axial pedicled propeller (APP) flap. Here we propose our updated and comprehensive classification of propeller flaps, taking into account the previous classification and subsequent publications. Based on their vascular pedicle, we consider the following five types of propellers: (1) SPP flap, 2.PPP flap, its subtype (2a) SCP flap, (3) APP flap, (4) muscle propeller flap, and (5) chimeric propeller flap. The variables that can be taken into account in the classification are as follows: type of nourishing pedicle, degrees of skin island rotation, position of the nourishing pedicle, artery of origin of the pedicle, and flap shape.
该术语由百束首次提出，用于定义一种基于皮下蒂中心的岛状皮瓣，该皮瓣旋转90度以纠正烧伤引起的瘢痕挛缩。随着穿支皮瓣的普及，推进运动首次应用于仅由单一穿支血管化的皮岛，“推进皮瓣”和“穿支皮瓣”这两个术语被一起使用。此后，推进皮瓣的手术技术不断发展，新的应用也不断涌现。在“东京共识”中，我们提出了推进皮瓣的定义和分类方案。推进皮瓣被定义为“通过轴向旋转到达受区的岛状皮瓣”。分类包括单穿支推进皮瓣（SPP）、穿支蒂推进皮瓣（PPP）及其亚型（2a）增压PPP皮瓣（SCP）。最近的一次更新增加了一个新类别，即轴型蒂推进皮瓣（APP）。在此，我们综合考虑先前的分类和后续的文献，提出推进皮瓣更新后的全面分类。基于其血管蒂，我们认为推进皮瓣有以下五种类型：（1）单穿支推进皮瓣，（2）穿支蒂推进皮瓣，其亚型（2a）增压PPP皮瓣，（3）轴型蒂推进皮瓣，（4）肌推进皮瓣，以及（5）嵌合推进皮瓣。分类中可考虑的变量如下：滋养蒂的类型、皮岛旋转的度数、滋养蒂的位置、蒂的起源动脉以及皮瓣形状。
