The profunda femoris artery "Fourth Perforator" island flap: a new perforator flap in lower-limb reconstruction

Rozen, Warren Matthew, Donahoe, Simon, and Wilson, Jeremy L. (2011) The profunda femoris artery "Fourth Perforator" island flap: a new perforator flap in lower-limb reconstruction. Journal of Reconstructive Microsurgery, 27 (4). pp. 273-276.

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Abstract

Although the lateral thigh flap has been well described as a fasciocutaneous flap based on one or more of the four perforators of the profunda femoris artery, the role for these individual perforators as perforator flaps has not been described. These profunda femoris artery perforators offer a particularly useful option in lower-limb reconstruction. In fact, a perforator flap based on the profunda femoris artery fourth perforator (PFA-P4) has not been described to our knowledge. We describe the utility of the PFA-P4 flap, offering modes of preoperative imaging and a role for its use in lower-limb reconstruction. Computed tomographic angiography (CTA) was able to identify the location and course of a PFA-P4, and Doppler ultrasound confirmed the CTA findings. A FA-P4 flap was designed and harvested, with direct closure of the donor site achieved. There were no operative complications. Perforator flaps based on the perforating branches of the profunda femoris artery have not been widely described, largely due to individual variability in perforator anatomy. With the advent of CTA for perforator mapping, the "freestyle" nature of such flaps is eliminated, and perforator flaps such as the PFA-P4 flap can be planned and harvested safely and confidently.

Item ID: 32405
Item Type: Article (Case Study)
ISSN: 1098-8947
Keywords: perforator flap; fasciocutaneous; preoperative imaging
Date Deposited: 28 Apr 2014 06:39
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 60%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110320 Radiology and Organ Imaging @ 40%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 50%
97 EXPANDING KNOWLEDGE > 970111 Expanding Knowledge in the Medical and Health Sciences @ 50%
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