The application of Taylor's concept about body angiosomes, referred to tissue transfers, has meant that the development of the perforator flaps and muscles is no longer needed as a carrier of skin flap vascularity. In this paper, we revise 59 lower limb reconstructions with local and free perforator flaps performed in the last 5 years, and a basic reconstructive algorithm is also suggested to help with the management of the lower limb soft tissue reconstruction with perforator flaps.
The advantages of the perforator flaps are (1) muscles and their function are preserved; (2) the main vascular trunks are spared; (3) it is possible to make a more specific reconstruction, replacing “like with like” (even performing compound or chimeric flaps); (4) the donor site can often be closed primarily; (5) the general morbidity is reduced; (6) a better cosmetic result can be achieved.
Fifty-nine lower-extremity reconstructions were performed with perforator flaps, 35 of them with a propeller design based on angiosomic distribution. Four flap losses were seen.
From the Department of Plastic Surgery, Hospital de la Santa Creu i Sant Pau (Universitat Autonoma de Barcelona), Barcelona, Spain.
Received July 4, 2006 and accepted for publication July 20, 2006.
No sources of support that require acknowledgment.
Reprints: Jaume Masia, MD, PhD, Chief of Department/Associate Professor, Department of Plastic Surgery, Hospital de la Santa Creu i Sant Pau (Universitat Autonoma de Barcelona), Sant Antoni M. Claret 167, 08025 Barcelona, Spain. E-mail: firstname.lastname@example.org.