THE “PROPELLER”-TECHNIQUE OF THE DISTAL LEG AND FOOT WOUNDS PLASTY

Introduction. The lower part of leg wounds reconstruction after acute battle trauma, mechanical and thermal injuries caused by the paucity of soft tissue resources in this region. Various procedures including skin grafting with or without negative pressure wound therapy and local random flaps have been used with varying degrees of success to cover lower leg or foot wounds. 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 12 propeller perforator flaps, which were performed in 11 patients with acute and chronic wounds involving the foot and lower leg. These patients were admitted beween 2014 and 2017. All flaps were based on perforators from the sural artery.

Results. A successful healing rate was obtained in 11 (92%) cases. Revisional surgery and skin grafting for skin necrosis was performed in two cases with one complete loss of the flap which led to a lower extremity amputation. The surgery was performed in the setting of infection and function disorder in all patients. Complete recovery of wounds was reached.

Conclusions. The purpose of this article is to review the use of propeller perforator flaps as an effective method for soft tissue coverage of the lower extremity and foot.