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The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

BACKGROUND: Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the pauci...

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Autores principales: Georgescu, Alexandru V., Matei, Ileana R., Capota, Irina M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3464067/
https://www.ncbi.nlm.nih.gov/pubmed/23050066
http://dx.doi.org/10.3402/dfa.v3i0.18978
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author Georgescu, Alexandru V.
Matei, Ileana R.
Capota, Irina M.
author_facet Georgescu, Alexandru V.
Matei, Ileana R.
Capota, Irina M.
author_sort Georgescu, Alexandru V.
collection PubMed
description BACKGROUND: Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin grafting (SG) with or without negative pressure wound therapy and local random flaps have been used with varying degrees of success to cover diabetic lower leg or foot ulcerations. Other methods include: local or regional muscle and fasciocutaneous flaps, free muscle and fasciocutaneous, or perforator flaps, which also have varying degrees of success. PATIENTS AND METHODS: This article reviews 25 propeller perforator flaps (PPF) which were performed in 24 diabetic patients with acute and chronic wounds involving the foot and/or lower leg. These patients were admitted beween 2008 and 2011. Fifteen PPF were based on perforators from the peroneal artery, nine from the posterior tibial artery, and one from the anterior tibial artery. RESULTS: A primary healing rate (96%) was obtained in 18 (72%) cases. Revisional surgery and SG for skin necrosis was performed in six (24%) cases with one complete loss of the flap (4%) which led to a lower extremity amputation. CONCLUSIONS: The purpose of this article is to review the use of PPF as an effective method for soft tissue coverage of the diabetic lower extremity and/or foot. In well-controlled diabetic patients that present with at least one permeable artery in the affected lower leg, the use of PPF may provide an alternative option for soft tissue reconstruction of acute and chronic diabetic wounds.
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spelling pubmed-34640672012-10-04 The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases Georgescu, Alexandru V. Matei, Ileana R. Capota, Irina M. Diabet Foot Ankle Clinical Research Article BACKGROUND: Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin grafting (SG) with or without negative pressure wound therapy and local random flaps have been used with varying degrees of success to cover diabetic lower leg or foot ulcerations. Other methods include: local or regional muscle and fasciocutaneous flaps, free muscle and fasciocutaneous, or perforator flaps, which also have varying degrees of success. PATIENTS AND METHODS: This article reviews 25 propeller perforator flaps (PPF) which were performed in 24 diabetic patients with acute and chronic wounds involving the foot and/or lower leg. These patients were admitted beween 2008 and 2011. Fifteen PPF were based on perforators from the peroneal artery, nine from the posterior tibial artery, and one from the anterior tibial artery. RESULTS: A primary healing rate (96%) was obtained in 18 (72%) cases. Revisional surgery and SG for skin necrosis was performed in six (24%) cases with one complete loss of the flap (4%) which led to a lower extremity amputation. CONCLUSIONS: The purpose of this article is to review the use of PPF as an effective method for soft tissue coverage of the diabetic lower extremity and/or foot. In well-controlled diabetic patients that present with at least one permeable artery in the affected lower leg, the use of PPF may provide an alternative option for soft tissue reconstruction of acute and chronic diabetic wounds. Co-Action Publishing 2012-10-01 /pmc/articles/PMC3464067/ /pubmed/23050066 http://dx.doi.org/10.3402/dfa.v3i0.18978 Text en © 2012 Alexandru V. Georgescu et al. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Georgescu, Alexandru V.
Matei, Ileana R.
Capota, Irina M.
The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases
title The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases
title_full The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases
title_fullStr The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases
title_full_unstemmed The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases
title_short The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases
title_sort use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3464067/
https://www.ncbi.nlm.nih.gov/pubmed/23050066
http://dx.doi.org/10.3402/dfa.v3i0.18978
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