Reconstruction of the Irregular Shape Defects Using the Free Polyfoliate Perforator Flaps

Introduction: The major advantage of the perforator flap is less morbidity of donor site than traditional flap. But for the super width and multiple defects, and irregular shape wounds including “T” shape, “L” shape etc., the donor site often couldn’t be closed primarily. The purpose of this article is to investigate the polyfoliate perforator flaps whose perforator vessels are all raised from the same source artery, and report the clinical results of repairing the complicated soft tissue defects in limbs.

Methodology and Material: Between September 2009 and June 2013, 21 soft tissue defects with irregular shape were repaired with the free polyfoliate perforator flaps. There were 18 bifoliate perforator flaps and 3 trifoliate flaps. In this series, and also it included 16 polyfoliate anterolateral thigh perforator flaps (PALTP), 3 polyfoliate posterior interosseous artery perforator flaps (PPIAP) and 2 polyfoliate medial sural artery perforator flaps (PMSAP). The sizes of unifoliate flaps ranged 2.5 cm × 2.0 cm～ 15 cm × 8.0 cm. All the wounds of donor site were closed primarily.

Results: All flaps survived except partial necrosis of unifoliate flap in two patients, which were repaired by skin graft finally. The clinical results were satisfactory after 3∼15 months of following-up, and the scars of the donor site were not obvious.

Conclusions: The longitudinal flap can be separated multiple flap paddles based on the perforator vessels and changed into a variety of shapes by means of versatile flap paddle combinations. The free polyfoliate perforator flap has a constant, reliable blood supply, and also is a good option for repairing the irregular shape defect in the limb.