000 03766nam a22004337a 4500
008 240807s20242024 xxu||||| |||| 00| 0 eng d
022 _a0974-3227
024 _aPMC11144646 [pmc]
024 _aS0974-3227(24)00035-8 [pii]
040 _aOvid MEDLINE(R)
099 _a38855530
245 _aPropeller Perforator Flaps Used for Hand and Digit Reconstruction: A Systematic Review.
251 _aJournal of Hand and Microsurgery. 16(2):100035, 2024 Jun.
252 _aJ. hand microsurg.. 16(2):100035, 2024 Jun.
253 _aJournal of hand and microsurgery
260 _c2024
260 _fFY2024
260 _p2024 Jun
265 _sepublish
265 _tPubMed-not-MEDLINE
266 _d2024-08-07
266 _z2024/06/10 05:38
520 _aBackground: Propeller perforator flaps (PPFs) have increased in popularity due to the freedom in design and ability to cover a variety of defects without sacrificing the major vessels. Present reports of PPFs for upper limb reconstruction have not provided guidance for hand reconstruction, specifically. This study aims to review the current literature and evaluate techniques for use of PPFs in hand reconstruction.
520 _aConclusion: PPFs are a reliable option for hand or digital reconstruction, allowing surgeons to cover a variety of defects without sacrificing local vasculature. Despite nearly a 20% reported complication rate, nearly all flaps with venous congestion and partial flap necrosis included in these articles resolved without the need for secondary intervention, retaining an excellent overall flap survival. Copyright © 2024 Society for Indian Hand Surgery and Micro Surgeons. Published by Elsevier B.V. All rights reserved.
520 _aMethods: A comprehensive literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles published from 1991 to 2021. The database search was queried for records using appropriate Medical Subject Headings (MeSH) terms. Studies reporting PPFs were limited to English language and excluded lower extremity or upper extremity reconstruction not specific to defects in the hand or digits. Study characteristics, patient demographics, indications, preoperative testing, flap characteristics, flap survival, and complication rates were collected.
520 _aResults: Out of the initial 1,348 citations yielded, 71 underwent full-text review. Ultimately, 25 unique citations were included encompassing 12 retrospective reviews (48%), 3 prospective cohort studies (10%), and 10 case series (40%). In review, 525 patients underwent reconstruction with a total of 613 propeller flaps performed to repair defects of the hand, digits, or both with use of 18 unique flap types. Overall flap survival was 97.8%. Acute wounds accounted for 72.9% of performed reconstructions. The mean flap coverage was 14.7 cm2. Complications occurred in 19.8% of cases, with venous congestion and partial flap necrosis occurring in 5.5 and 6.5% of cases, respectively, leading to a flap failure rate of 2.1%.
546 _aEnglish
650 _zAutomated
651 _aCurtis National Hand Center
656 _aMedStar General Surgery Residency
656 _aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
657 _aJournal Article
700 _aDeldar, Romina
_bMGUH
_cMedStar General Surgery Residency
_dMD
700 _aGiladi, Aviram M
_bCURT
700 _aSgromolo, Nicole
_bCURT
790 _aBovill J, Huffman S, Cach G, Haffner Z, Deldar R, Abu El Hawa AA, Sgromolo N, Giladi AM
856 _uhttps://dx.doi.org/10.1055/s-0043-1768482
_zhttps://dx.doi.org/10.1055/s-0043-1768482
942 _cART
_dArticle
999 _c14485
_d14485