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Evolution of local perforator flaps in lower extremity reconstruction

Plastic and Aesthetic Research 2019年第12期6卷 1-13页

作者： Rachel Cohen-Shohet Mariel McLaughlin David Kerekes Harvey Chim Plastic and Reconstructive Surgery University of FloridaGainesvilleFL 32608USA

Lower extremity reconstruction is challenging for a variety of *** techniques for soft tissue coverage continue to *** free flaps are always an option,free flaps require significant microsurgical expertise,a proficient staff,advanced equipment,and a patient with a somewhat healthy ***,as microsurgery has evolved,so has the identification of new anatomy and new techniques-namely,perforator based pedicled *** flaps have expanded options for lower extremity reconstruction,and continue to advance the field of *** purpose of this article is to review the evolution of perforator based pedicled flaps in the lower extremity,review the anatomy,and offer examples of design and indications.

关键词： perforator flaps lower extremity reconstruction soft tissue coverage

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Advances in microsurgery for upper and lower extremity reconstruction and limb preservation

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Plastic and Aesthetic Research 2019年第10期6卷 1-14页

作者： Alberto Bolletta Rubino Corrado Hung-Chi Chen Department of Plastic Surgery China Medical University HospitalTaichung 404Taiwan Department of Medical Surgical and Experimental SciencesUHT of SassariPlastic Surgery UnitUniversity of SassariSassari 07100Italy

In the recent decades,microsurgical reconstruction has evolved from simple survival of the affected extremity to the improvement of functional and aesthetic *** review retraces the main contributions to the advances of microsurgery for reconstruction of upper and lower extremities and limb *** the upper extremity,it is important to restore fine motility,together with allowing prompt *** the lower limb,care must be taken in the reconstruction of weight-bearing areas and the aim must be proper ambulation and shoe *** perforator flaps can be considered for medium size *** provide thin coverage and can be performed in short operating *** use,though,is often limited by tissue *** flaps allow to overcome this problem and,thanks to the recent development in the study of perforator vessels,the microsurgeon can choose the flap with the most appropriate *** flaps can accomplish simultaneous reconstruction of different tissue components and large bone defects often require vascularized bone *** dealing with limb preservation it is very important to consider residual *** muscle transfer and targeted muscle re-innervation can be performed in these cases.A useful reconstructive tool in severely damaged limbs with limited blood supply is the use of cross-leg free *** conclusion,extremity reconstruction and limb preservation are reaching new heights thanks,not only to the work of plastic surgeons,but also to the new developments in other fields of study such as oncology,traumatology,radiology and medical engineering.

关键词： Extremity reconstruction functional and aesthetic outcome limb salvage perforator flaps free flaps weight-bearing areas cross-leg flaps

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