Journal of reconstructive microsurgery最新文献

{"title":"Risk of Plate Exposure in Vascularized Fibula Flap for Mandibular Reconstruction in Primary Oral Cancers.","authors":"Ashwin Alke Pai, Angela Chien-Yu Chen, Charles Yuen Yung Loh, Shao-Yu Hung, Chung-Kan Tsao, Huang-Kai Kao","doi":"10.1055/a-2540-0737","DOIUrl":"10.1055/a-2540-0737","url":null,"abstract":"<p><p>To investigate the risk factors for plate exposure in primary oral cancer patients with mandibular defects undergoing tumor ablation followed by vascularized free fibular flap (FFF) transfer, we conducted a retrospective observational STUDY IN A SINGLE INSTITUTION IN TAIWAN: .The study was performed on a total of 292 primary oral cancer patients who underwent FFF reconstruction between 2015 and 2019. A variety of clinicopathological, surgical, and postoperative parameters were identified and assessed. The data were statistically analyzed with univariate and multivariate logistic regression, and the probability of plate exposure-free rate was plotted as Kaplan-Meier survival curve.The overall plate exposure rate was 28.76%. The re-exploration group had a higher rate of plate exposure than patients without re-exploration (12.2% vs. 5%, <i>p</i> < 0.05). The 3-year probability of plate exposure-free rates in patients with (<i>n = 216</i>) and without (<i>n = 76</i>) postoperative radiotherapy were 65.9 and 92.5%, and in patients with (<i>n = 141</i>) and without (<i>n = 151)</i> postoperative wound infection were 55.3 and 91.2%, respectively. The multivariate logistic regression showed postoperative radiotherapy and wound infection were independent risk factors for developing plate exposure (adjusted odds ratio [95% CI]: 3.73 [1.37-10.68] and 10.71 [5.15-22.26], <i>p</i> = 0.01 and <i>p</i> <0.001, respectively). More patients required surgical intervention to manage the exposure of hardware.Our study has highlighted that postoperative radiotherapy and postoperative wound infection are independent risk factors for plate exposure.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"802-809"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Variables Associated with Lymphedema Surgery: Physiologic versus Excisional.","authors":"Jayna Lenders, Christine S W Best, Zachary J Eisner, Theodore A Kung","doi":"10.1055/a-2508-6778","DOIUrl":"10.1055/a-2508-6778","url":null,"abstract":"<p><p>As surgical interventions for lymphedema become increasingly available, it is important to understand characteristics of patients that undergo lymphedema surgery. The goal of this study was to define clinical variables of patients evaluated at a medical center who underwent lymphedema surgery to better inform which referred patients are surgical candidates.A cross-sectional observational study was performed on patients referred to plastic surgery for lymphedema between January 2016 and June 2023. The operative group included patients who underwent lymphedema surgery, including physiologic surgery (PS) and excisional surgery (ES). The nonoperative group consisted of patients referred for lymphedema who did not undergo lymphatic surgery. Patient records were collected, and between-group comparisons were performed.A total of 285 total patients were identified (<i>n</i> = 66 operative, <i>n</i> = 219 nonoperative). The operative cohort had higher body mass index (BMI) than the nonoperative (33.5 vs. 31.2 kg/m², <i>p</i> < 0.035) and was more likely to have undergone physical therapy/occupational therapy (68.2 vs. 53.4%, <i>p</i> = 0.005). Within the operative cohort (PS = 37, ES = 29), PS patients were more likely to be White (91.9 vs. 69.0%, <i>p</i> = 0.043) and have lower BMI (32 vs. 42.7 kg/m², <i>p</i> = 0.007). PS patients were diagnosed for a longer period (8 vs. 3 years, <i>p</i> = 0.03) before seeing a plastic surgeon, more commonly had upper extremity lymphedema (43.2 vs. 13.8%, <i>p</i> = 0.016) and presented at an earlier lymphedema stage (stage 1 64.9 vs. 27.6%, <i>p</i> = 0.002). PS patients were more likely to have prior radiation (56.8 vs. 20.7%, <i>p</i> = 0.005), previous surgery (75.5 vs. 48.3%, <i>p</i> = 0.038), and prior lymphatic intervention (67.6 vs. 17.2%, <i>p</i> < 0.001) near the affected area.Defining patient characteristics associated with surgical intervention for lymphedema can aid surgeons to increase the proportion of patients seen in clinic who are surgical candidates. Factors relating to oncological and surgical history in the affected area may suggest a patient is more likely to undergo PS.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"752-760"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgeon Development, Attrition, and Hope for the Future: A Qualitative Analysis.","authors":"Jaclyn T Mauch, Yasmeen M Byrnes, Alesha A Kotian, Hannah Z Catzen, Mary E Byrnes, Paige L Myers","doi":"10.1055/a-2483-5337","DOIUrl":"10.1055/a-2483-5337","url":null,"abstract":"<p><p>The field of microsurgery continues to grow, yet barriers to practice still exist. This qualitative study aims to elucidate factors both strengthening and threatening this subspecialty through structured interviews with fellowship-trained microsurgeons.An interview guide was designed, and structured interviews were conducted with practicing fellowship-trained microsurgeon members of the American Society of Reconstructive Microsurgeons between August 2021 and May 2022. Three independent reviewers transcribed, content-coded, and thematically analyzed the interviews. Themes and subthemes were discussed and finalized.Twenty-one practicing microsurgeons were interviewed, hailing from all four Census geographical regions of the United States. The most common practice model was academic (43%, <i>n</i> = 9). Five overarching themes emerged: a passion for microsurgery, training and mentorship, practical considerations, team support, and hope for the future. Microsurgeons reported early exposure to microsurgery as catalyzing their passion, whereas a strong training foundation and lifelong mentors sustained it. Practical challenges arose when establishing and maintaining a microsurgery practice, such as poor reimbursement and unfavorable referral patterns. Team support from staff and other microsurgeons (e.g., a co-surgeon model) was crucial to success. Finally, microsurgeons hoped that future advances would expand access to microsurgical reconstruction for patients and plastic surgeons.This unique, qualitative description of the current landscape of microsurgery revealed that though practical barriers exist, team-based models can alleviate some difficulties. Future advances that increase accessibility may further strengthen this unique and versatile field.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"660-666"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Vascular Anatomy and Harvesting of the Lateral Femoral Condyle Flap in Pigs.","authors":"Yanhai Zuo, Shouyun Xiao, Xinchu Zhou, Lei Yi","doi":"10.1055/a-2486-8741","DOIUrl":"10.1055/a-2486-8741","url":null,"abstract":"<p><p>Clinically, there has been increasing employment of the lateral femoral condyle flap. The objective of this study was to explore the vascular anatomy of the lateral femoral condyle in pigs and to explore the feasibility of using pigs as an animal model of the lateral femoral condyle flap.A total of 20 fresh cadaveric hindlimbs of 4-week-old hybrid pigs were used in this study. The origination, course, and branches of the nourishing vessels of the lateral femoral condyle were observed in 15 specimens. The primary parameters included the variability in the anatomy of the vessels and the length and outer diameter of the vessels. Surgical procedures for the lateral femoral condyle flap were conducted on five specimens.The primary nourishing arteries of the lateral femoral condyle in pigs were the first superolateral geniculate artery, which was observed in all 15 specimens and had a diameter and length of 1.99 ± 0.44 mm and 2.27 ± 0.46 cm, respectively, as measured at their origination. The operation was performed in the lateral position. A 10-cm skin incision was made from the lower edge of the patella to the posterior lateral side of the distal femur. After blunt dissection of the intermuscular septum between the biceps femoris and vastus lateralis, the whole course of the first superolateral geniculate artery was exposed.The vascular anatomy of the lateral femoral condyle in pigs and that of humans exhibited great similarities. The harvesting of the lateral femoral condyle flap in pigs was as easy as that in humans. Pigs could serve as a suitable animal model for the lateral femoral condyle flap.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"667-673"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free Fasciocutaneous versus Muscle Flaps in Lower Extremity Reconstruction: Implications for Functionality and Quality of Life.","authors":"Emile B List, Brett A Hahn, Shan S Qiu, Tim de Jong, Hinne A Rakhorst, Elfi M Verheul, Wiesje Maarse, J Henk Coert, David D Krijgh","doi":"10.1055/a-2483-5388","DOIUrl":"10.1055/a-2483-5388","url":null,"abstract":"<p><p>Free tissue transplantations are commonly used to treat complex lower extremity defects caused by trauma, vascular disease, or malignancy, particularly when vital structures are exposed. This study aimed to expand the knowledge on patient-reported outcomes by comparing fasciocutaneous and muscle flaps, with the goal of facilitating patient counseling. Additionally, patient-level risk factors associated with decreased functioning and health-related quality of life were identified.This retrospective, cross-sectional, multicenter study included patients who underwent microsurgical lower extremity reconstruction using free fasciocutaneous or muscle flaps between 2003 and 2021, with a minimum follow-up of 12 months. Data were collected from medical records, pain scores, Short-Form 36 (SF-36), and Lower Extremity Functional Scale (LEFS). Mean scores were compared between flap types and predictors of LEFS, SF-36 mental component summary (MCS), and SF-36 physical component summary (PCS) scores were determined using a backward stepwise regression model.Of the 206 patients eligible, 100 (49%) were included in the retrospective part. A total of 89 (43%) responded to the questionnaires, with 62 treated using a fasciocutaneous flap and 27 with a muscle flap. No significant differences in total LEFS, SF-36 PCS, or MCS scores were found between the two flap type. Pain was a significant predictor of decreased functional outcomes for both flap types and was also linked to poorer mental health in patients treated with fasciocutaneous flaps. Other predictors of low patient-reported outcome scores included obesity, diabetes, poorer mental health, and a follow-up of less than 2 years.Patients treated with fasciocutaneous and muscle flaps experience comparable levels of functionality and quality of life after surgery. Flap selection should be based on defect characteristics, along with the surgeon's individual skills and preferences. A comprehensive approach that considers physical comorbidities, pain, and mental health is essential, as these factors significantly impact patient functionality and quality of life.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"641-648"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncoplastic Surgery with Volume Replacement versus Mastectomy with Implant-Based Breast Reconstruction: Early Postoperative Complications in Patients with Breast Cancer.","authors":"Gabriel De La Cruz Ku, Anshumi Desai, Meera Singhal, Michael Mallouh, Caroline King, Alexis N Rojas, Sarah Persing, Christopher Homsy, Abhishek Chatterjee, Salvatore Nardello","doi":"10.1055/a-2491-3110","DOIUrl":"10.1055/a-2491-3110","url":null,"abstract":"<p><p>Two common surgical approaches for breast cancer are breast-conserving surgery and mastectomy with implant-based breast reconstruction (MIBR). However, for large tumors, an alternative to MIBR is oncoplastic surgery with volume replacement (OPSVR). We performed a comprehensive analysis comparing OPSVR with MIBR, with our aim to focus on the 30-day postoperative complications between these two techniques.We conducted a retrospective cohort study using the National Surgical Quality Improvement Program (NSQIP) database from 2005 to 2020. Only breast cancer patients were included and were divided according to the surgical technique: OPSVR and MIBR. Logistic regression analysis was used to assess independent risk factors for total, surgical, and wound complications.A cohort of 8,403 breast cancer patients was analyzed. A total of 683 underwent OPSVR and 7,720 underwent MIBR. From 2005 to 2020, the adoption of OPSVR gradually increased over the years (<i>p</i> < 0.001), whereas MIBR decreased. OPSVR patients were older (57.04 vs. 51.89 years, <i>p</i> < 0.001), exhibited a higher body mass index (31.73 vs. 26.93, <i>p</i> < 0.001), had a greater prevalence of diabetes mellitus (11.0 vs. 5.0%, <i>p</i> < 0.001). They also had a higher ASA classification (2.33 vs. 2.15, <i>p</i> < 0.001), shorter operative time (173.39 vs. 216.20 minutes, <i>p</i> < 0.001), and a higher proportion of outpatient procedures (83.7 vs. 39.5%, <i>p</i> < 0.001). Outcome analysis demonstrated fewer total complications in the OPSVR patients (4.2 vs. 10.9%, <i>p</i> < 0.001), including lower rates of surgical complications (2.2 vs. 8.0%, <i>p</i> < 0.001) and wound complications (1.9 vs. 4.8%, <i>p</i> = 0.005) compared with MIBR patients. Multivariate analysis identified OPSVR as an independent protective factor for total, surgical, and wound complications.OPSVR has become a favorable technique for patients with breast cancer. Even in patients with higher comorbidities, OPSVR demonstrates safe and better outcomes when compared with MIBR. It should be considered a reasonable and safe breast surgical option in the appropriate patient.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"674-683"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic Status Impacts Ambulatory Outcomes in Lower Extremity Flap Reconstruction.","authors":"Eloise W Stanton, Artur Manasyan, Idean Roohani, Erin Wolfe, David A Daar, Joseph N Carey","doi":"10.1055/a-2491-3564","DOIUrl":"10.1055/a-2491-3564","url":null,"abstract":"<p><p>There is a lack of literature regarding the effects of language barriers, socioeconomic status, racial disparities, and travel distance to the hospital on the outcomes of lower extremity (LE) flap reconstruction. Consequently, this study assesses the potential influence of these factors on ambulation within this specific patient demographic.A retrospective review was performed between 2007 and 2022 of patients who underwent LE reconstruction with tissue flap placement at a single institution. The primary outcome was ambulation status, with cohorts compared between those who were ambulatory versus nonambulatory. Covariates included race, age, gender, primary language, distance from patient home to hospital, socioeconomic status (determined using area deprivation index [ADI]), and flap characteristics. Outcomes were assessed with multivariable logistic regression.A total of 242 patients who underwent LE flap reconstruction during the study period. The average time to final ambulatory status was 7.0 months (standard deviation: 11.0), with 51.7% requiring either a wheelchair or assistance device and 48.4% being fully ambulatory at final follow-up. The average state ADI for the cohort was 5.8, with Hispanic patients having significantly higher deprivation indexes (6.3 vs. 5.6, <i>p</i> < 0.001). Multiple logistic regression demonstrated that when controlling for numerous covariates, patients in the highest 15th percentile of deprivation were significantly less likely to be fully ambulatory at final follow-up (odds ratio: 0.22, 95% confidence interval: 0.061-0.806, <i>p</i> = 0.022).The current study emphasizes the substantial impact of socioeconomic disparities on postoperative outcomes in LE flap reconstruction. The finding that patients in the highest 15th percentile of deprivation were less likely to achieve full ambulation underscores the need to prioritize socioeconomic factors in clinical consideration and highlights a crucial avenue for future research.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"703-708"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Microsurgery During Bilateral Autologous Breast Reconstruction Reduces Ischemia Time Without Increasing Complications.","authors":"Jacquelyn M Roth, Maxwell Godek, Jamie Frost, Bernice Yu, Ethan Fung, Hani Sbitany, Jordan M S Jacobs, Steven M Sultan, Rebecca Suydam, Peter W Henderson","doi":"10.1055/a-2702-4108","DOIUrl":"10.1055/a-2702-4108","url":null,"abstract":"<p><p>In bilateral deep inferior epigastric perforator (DIEP) flap reconstruction procedures, the microsurgical anastomoses are usually performed consecutively, where one side is completed before the other side is started. However, when a co-surgeon model and loupe magnification are used, it is possible to perform both sides simultaneously. This study assesses the implications of simultaneous versus consecutive microsurgery on ischemia time and postoperative outcomes in bilateral DIEP flap reconstruction.A retrospective chart review was conducted on bilateral DIEP flap breast reconstruction patients between 2017 and 2023. Ischemia time was used to categorize the microsurgical anastomosis, with an overlap of 10 or more minutes between sides classified as \"simultaneous microsurgery,\" and an overlap of less than 10 minutes classified as \"consecutive microsurgery.\" Data were collected on patient demographics, total ischemia time (total time when one or both sides of the abdomen were undergoing microsurgical anastomoses), total operating time, postoperative complications, 90-day postoperative events, hospital length of stay (LOS), and morphine milligram equivalents (MME) required for pain management. Regression analyses assessed the impact of simultaneous versus consecutive microsurgery on key outcomes. Statistical significance was set at <i>p</i> < 0.05.Seventy-four patients met the inclusion criteria for this study. Thirty-one (42%) had undergone simultaneous microsurgery, and 43 (58%) had undergone consecutive microsurgery. There were no significant differences between the two groups in age, body mass index (BMI), race, ethnicity, or baseline comorbidities. Univariate analysis revealed a statistically significant reduction in total ischemia time associated with simultaneous microsurgery (111 minutes vs. 147 minutes; <i>p</i> < 0.001), and no differences in total operating time, complications, 90-day postoperative events, LOS, or MME. These findings were unchanged on multivariate regression controlling for age, BMI, comorbidities, and flap weight.Simultaneous microsurgery during bilateral DIEP flap reconstruction significantly reduces total ischemia time without increasing complications, hospital LOS, or pain management requirements.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Concept in Peripheral Nerve Repair: Incorporating the Tunica Adventitia.","authors":"Moath Zuhour, Bilsev İnce, Pembe Oltulu, Orhan Gök, Zülal Tekecik","doi":"10.1055/a-2491-3447","DOIUrl":"10.1055/a-2491-3447","url":null,"abstract":"<p><p>Pedicled, prefabricated, and free nerve flaps have several drawbacks, such as requiring microsurgical anastomosis, the need for secondary operations and the risk of developing thrombosis. In this study, we aimed to vascularize the repaired nerve in a single session by establishing a connection between the epineurium of the repaired median nerve and the tunica adventitia of the brachial artery.The technique was performed on the median nerves of a total of 42 rats over 13 weeks. While group 1 didn't receive any intervention, the following three groups (2, 3, and 4) received classic treatments (coaptation, graft, and vein conduit). In addition to classic treatments, the other three groups (5, 6, and 7) were vascularized by attaching the adventitia of the brachial artery to the repaired nerves. Nerve regeneration was evaluated using functional tests, immunohistochemical analysis, and electron microscope.The vascularized groups (5, 6, and 7) showed earlier functional recovery (<i>p</i> < 0.05). Vascularization reduced inflammation in the coaptation group, reduced fibrosis and degeneration in the nerve graft group, and reduced fibrosis, degeneration and disorganization while increased the number of passing fibers and myelination in the vein conduit group (<i>p</i> < 0.05). Vascularization provided superior ultrastructural findings. Microscopic analysis revealed a novel finding of \"zone of neurovascular interaction\" between the adventitia and the regenerating nerve.Vascularizing the repaired nerves with this new technique provided faster functional and better histological healing. Unlike classic vascularization techniques, this method does not require microsurgical anastomosis, does not carry the risk of thrombosis, and does not necessitate secondary operations. The \"zone of neurovascular interaction\" identified in this study revealed regenerating axon clusters alongside newly developed blood vessels. This important finding highlights a potential role of the tunica adventitia in nerve regeneration.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"719-731"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing Perforator Propeller Flaps for Donor Site Closure: Harvesting Large Workhorse Flaps without Lingering Concerns.","authors":"Tinglu Han, Nima Khavanin, Mengqing Zang, Shan Zhu, Shanshan Li, Zixiang Chen, Shengyang Jin, Yuanbo Liu","doi":"10.1055/a-2491-3511","DOIUrl":"10.1055/a-2491-3511","url":null,"abstract":"<p><p>Primary closure of donor sites following large flap harvest may not be feasible. The use of perforator propeller flap (PPF) in this setting is gaining popularity, successfully resurfacing the wound and lessening potential donor-site morbidity. In this study, we aimed to review our experience and outcomes using PPFs in donor-site coverage throughout the body.A retrospective chart review was performed of all patients who underwent one or more PPFs surgery for donor site resurfacing between February 2009 and December 2021. Flap and defect characteristics were summarized. Postoperative complications and perioperative factors were analyzed.Fifty-five patients underwent donor-site reconstruction using 68 PPFs. Of the 55 primary donor sites, 44 were covered with a single PPF, 9 with two PPFs, and 2 with three PPFs. One flap experienced complete necrosis and four flaps experienced distal flap necrosis, leading to an overall complication rate of 9.1%. No risk factors were found to be statistically significantly associated with the complication. All secondary PPF donor sites were closed primarily. During the average follow-up period of 15.1 months, none of the patients developed contour deformities or functional impairments.The PPF technique can be safely and effectively used for donor-site closure with minimal complications. It greatly frees surgeons to harvest a large workhorse flap for demanding soft tissue defect reconstruction.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"709-718"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}