Comparison of the Clinical Efficacy of Perforator Pedicled V-Y Flap and Perforator Pedicled Propeller Flap in Repairing Small Area Soft Tissue Defects: A Retrospective Comparative Study

Abstract

Background and Aims

Primary medical institutions commonly employ perforator-pedicled propeller (PPP) flaps and V-Y flaps as the main methods for managing small soft tissue defects resulting from trauma or lesion resection. However, both surgical techniques have inherent limitations. Therefore, this study aims to investigate the feasibility of utilizing perforator-pedicled (PP) V-Y flaps for reconstructing small area soft tissue defects and evaluate their clinical effectiveness.

Methods

The study conducted a retrospective analysis from January 2010 to December 2022, involving 49 patients with small soft tissue defects resulting from trauma or lesion resection (21 PP V-Y flaps and 28 PPP flaps). Evaluation criteria encompassed intraoperative conditions, postoperative short- and long-term complications, and aesthetic outcomes.

Results

The results of this study showed that all flaps in the PP V-Y flap group survived, while six cases in the PPP flap group had partial necrosis. The donor area was closed directly in one stage for the group of perforator pedicled V-Y flaps, while skin grafting was required to repair the donor area for eight cases from the group of PPP flaps, leading to delayed healing in this region. Furthermore, aesthetic evaluation favored PP V-Y flaps as they exhibited significantly better appearances in both donor and recipient areas.

Conclusion

In this study, compared to the PPP flap, the PP V-Y flap demonstrates superior outcomes with regard to reduced postoperative complications and enhanced aesthetic appearance. PP V-Y flap is an ideal technique for repairing small soft tissue defects of limbs, which is suitable for implementation in primary medical institutions.

Level of evidence: III, Case–control study.