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The Use Of Propeller Perforator Flaps In Elbow Reconstruction
Dinu Iuliu Dumitrascu, MD, PhD1; Alexandru Georgescu, Prof, MD, PhD2, UMF Cluj, Cluj-Napoca, Romania; Plastic Surgery and Reconstructive Microsurgery Clinic, UMF Iuliu
Hatieganu, Cluj Napoca, Romania

Introduction: The elbow region is a very challenging area to reconstruct. The difficulty is due to two reasons: elbow's joint high tendency to stiffness and the abundance of neuro-vascular structures in the area. The paper presents a series of cases where elbow defects were reconstructed with propeller perforator flaps. In our hands, this method is very efficient by reducing both the intraoperative time as well as the postoperative rehabilitation period.

Materials and methods: 21 patients from our service in 2016 were included in the study. The defects were either posttraumatic or post surgical. The coverage was done with propeller perforator flaps based on pedicles originating in from the anastomotic elbow vascular circle. In 12 cases the closure of the donor area was done by direct suture, in the other cases skin grafting was necessary. The physical therapy was initiated starting from the first postoperative day.

Results: We experienced a 100% flap survival. In 6 patients, a marginal necrosis of the flap occurred. Secondary skin grafting due to complications was done in 2 cases. Both patients and surgeons were satisfied bye the cosmetic and functional results.

Conclusions: Soft tissue defects coverage in the elbow, using propeller perforator flaps is a safe procedure. The intraoperative times are shorter if compared with free flaps surgery times. Physical therapy is started from the first postoperative day. The patients appreciate the aesthetic end result.

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