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The Versatility of Propeller Flaps for Lower Limb Reconstruction in Patients With Peripheral Arterial Obstructive Disease: Initial Experience

Jiga, Lucian P. MD, PhD*; Barac, Sorin MD*; Taranu, Georgel MD*; Blidisel, Alexandru MD, PhD*†; Dornean, Vlad MD*; Nistor, Alexandru MD*; Stoichitoiu, Teodora MD*; Geishauser, Max MD, PhD*‡; Ionac, Mihai MD, PhD*

doi: 10.1097/SAP.0b013e3181a72f8c
Reconstructive Surgery and Burns

In this study, we evaluate the feasibility of propeller flaps, for soft tissue reconstruction in patients with peripheral arterial obstructive disease (PAOD). Five patients (average age, 72 years old), presenting with necrosis of several foot units, were diagnosed with stage IV PAOD and diabetes mellitus. All underwent revascularization, followed by soft tissue reconstruction using propeller flaps. A total of 6 flaps were performed, with dimensions ranging from 4 × 7 cm to 8 × 31 cm. Perforator origin was the peroneal (5 flaps) or the tibial posterior artery (1 flap). Average operative time was 190 minutes. Overall patency was 83.3%; 1 case was complicated with total flap loss followed by below-knee amputation; 1 case developed partial necrosis necessitating skin grafting. All flaps developed mild postoperative edema, which resolved spontaneously. Propeller flaps prove to be useful tools for soft tissue reconstruction in patients with PAOD because of low operative morbidity, easy technique with fast learning curve, and low complications rate.

From the *Division for Reconstructive Microsurgery, Clinic of Vascular Surgery, General County Emergency Hospital, Timisoara, Romania; †Department of Surgery, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; and ‡Plastische Chirurgie, Muenchen, Germany.

Received January 1, 2009, and accepted for publication, after revision, March 25, 2009.

Supported, in part, by the Research Grant ID1263/2007-Exploratory research projects–awarded by CNCSIS (Romanian National Council for Scientific Research).

Reprints: Lucian P. Jiga, MD, PhD, Center for Laparoscopic Surgery and Microsurgery, Victor Babes University of Medicine and Pharmacy, P-ta Eftimie Murgu, Nr. 2, Timisoara, 300041–RO (Romania). E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.