Article Abstract

A new operative technique for dissecting perforator vessel in perforator flap: a better way to minimize donor-site morbidity

Authors: Limin Qing, Panfeng Wu, Zhouzheng Bing, Fang Yu, Xiaoyang Pang, Pan Ding, Xiaoyong Bing, Zeng Lei, Jinfei Fu, Juyu Tang


Background: The purpose of this paper was to introduce our experience on a new operative technique for dissecting perforator vascular in the perforator flap and explore its clinical outcome.
Methods: Between June 2013 and December 2016, 119 patients underwent soft tissue defects reconstruction with anterolateral thigh perforator flaps (ALTPs) were included in this study. Ninety-eight patients were male, and twenty-one patients were female. The average age of those patients was 40.58 years.
Results: The ALTPs were successfully elevated to reconstruct soft tissue defect for 119 patients. The size of skin paddle was 120.59±59.31 cm2. A total of 148 perforators were included in the ALTP (84 percent was musculocutaneous perforator, 16 percent was septocutaneous perforator). The mean flap elevation time was 60.85±20.25 minutes. The success rate of flap elevation was 98%, only three perforators were injured and one perforator occurred vasospasm during the operation. Five cases, including three venous crisis and two artery crisis, presented with vascular crisis after flap transfer. The rate of vascular crisis was 4.2%. All of flaps were completely survived except one flap had partial flap necrosis. The mean follow-up time was 13.32±8.9 months. No muscular weakness was displayed in this group.
Conclusions: Orderly retrograde dissection of the perforator vessels in the perforator flap can provide with less donor site morbidity, shorter operative time and safer than the traditional methods. It is a reliable operation for elevating the perforator flap.