Freestyle multiple propeller flap reconstruction (jigsaw puzzle approach) for complicated back defects

Journal of Reconstructive Microsurgery
Sung Woo ParkJoon Pio Hong

Abstract

The reconstruction of the posterior trunk remains to be a challenge as defects can be extensive, with deep dead space, and fixation devices exposed. Our goal was to achieve a tension-free closure for complex defects on the posterior trunk. From August 2006 to May 2013, 18 cases were reconstructed with multiple flaps combining perforator(s) and local skin flaps. The reconstructions were performed using freestyle approach. Starting with propeller flap(s) in single or multilobed design and sequentially in conjunction with adjacent random pattern flaps such as fitting puzzle. All defects achieved tensionless primary closure. The final appearance resembled a jigsaw puzzle-like appearance. The average size of defect was 139.6 cm(2) (range, 36-345 cm(2)). A total of 26 perforator flaps were used in addition to 19 random pattern flaps for 18 cases. In all cases, a single perforator was used for each propeller flap. The defect and the donor site all achieved tension-free closure. The reconstruction was 100% successful without flap loss. One case of late infection was noted at 12 months after surgery. Using multiple lobe designed propeller flaps in conjunction with random pattern flaps in a freestyle approach, resembling putting a jigsaw...Continue Reading

Citations

May 2, 2017·Plastic and Reconstructive Surgery. Global Open·Asli DatliJoon Pio Jp Hong
Jan 28, 2020·Annals of Plastic Surgery·Michele MarucciaEmanuele Cigna
Jul 26, 2017·Plastic and Reconstructive Surgery. Global Open·Joon Pio Jp HongHyunSuk Peter Suh
May 23, 2020·Plastic and Reconstructive Surgery. Global Open·Faris M AlMugarenJoon Pio Hong
Jul 1, 2020·Journal of Surgical Oncology·Han Gyu ChaHyunsuk Peter Suh
Jun 17, 2020·Annals of Plastic Surgery·Jochen-Frederick HernekampUlrich Kneser
Oct 13, 2020·Seminars in Plastic Surgery·Daniel J KedarJoon Pio Hong

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