Freestyle Perforator Puzzle Flap for Posterior Trunk Reconstruction.

Abstract:

BACKGROUND:Closure of extensive defects of posterior trunk can be challenging for reconstructive surgeons owing to the need of a large bulk of well-vascularized tissue to resurface the skin and the exposed hardware and to fill the dead spaces. We hypothesized that elevating multiple perforators flaps in various patterns would allow for reconstruction of large posterior trunk defects with tension-free primary closure and minimal donor site morbidity. PATIENTS AND METHODS:Between January 2013 and December 2016, 23 patients with large posterior trunk defects underwent reconstruction with a multiple freestyle perforator flaps approach. We experimented a freestyle perforator-based reconstruction, which consists of designing a sequence of flaps, able to adequately fit the defects, allowing for tensionless primary closure. RESULTS:The average age of patients was 60.2 years (range, 18-80 years). A total number of 62 perforator flaps was performed, with an average of 2.6 flaps per patient. We were able to successfully cover defects up to 27 × 29 cm. A single perforator was used in 58 flaps, whereas more than 1 perforator was applied in 4 flaps. In all cases, the donor sites were closed primarily, and patients healed uneventfully. Six patients underwent radiotherapy after surgery, but no complication occurred. CONCLUSIONS:In this series of extensive defects of the posterior trunk, a tension-free closure was achieved by distributing the tension to multiple freestyle perforator flaps, supplying sufficient volume of tissue and reliable vascularization. This approach can be a valid tool in facing reconstruction of large and complicated defects of the posterior trunk.

journal_name

Ann Plast Surg

authors

Maruccia M,Di Taranto G,Schonauer F,DʼAndrea F,Losco L,Ribuffo D,Chen HC,Cigna E

doi

10.1097/SAP.0000000000002259

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

56-60

issue

1

eissn

0148-7043

issn

1536-3708

journal_volume

85

pub_type

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