Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(02): 192-197
DOI: 10.1055/s-0040-1714223
Artigo Original
Mão

Use of Propeller Flap in the Coverage of Soft-Tissue Injury in the Lower Limb[*]

Article in several languages: português | English
Adison de Souza Valente 
1   Departamento de Ortopedia e Traumatologia, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brasil
,
Denis Ferreira de Borba 
1   Departamento de Ortopedia e Traumatologia, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brasil
,
Daniel Ribeiro de Resende 
1   Departamento de Ortopedia e Traumatologia, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brasil
,
Meyrelles Rodrigues Resende 
1   Departamento de Ortopedia e Traumatologia, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brasil
,
Ricardo Gouvea Goulart 
1   Departamento de Ortopedia e Traumatologia, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brasil
,
Sérgio José de Lima 
1   Departamento de Ortopedia e Traumatologia, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brasil
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective To evaluate the use of a propeller flap to cover soft-tissue injuries in the lower limb.

Materials and Methods A retrospective study, with review of medical records, and a convenience sample of 14 patients operated between July 2018 and June 2019. The following clinical aspects were evaluated: sex; age group; type of injury; cause of the injury; initial diagnosis; affected location; techniques for incision and identification; surgical planning; flap design; postoperative period; result of the propeller flap; and complications.

Results The sample was composed of male patients (100%), with a mean age of 36.4 years, and 92.7% of the injuries resulted from motorcycle accidents, mostly on the right side (71.4%). The surgical planning of the propeller flap followed the same procedure in all cases. Immediate postsurgical complications were present in 35.7% of the cases, and they included excessive bleeding (14.3%), partial necrosis (14.3%), and flap dehiscence (7.1%). In total, 13 patients had excellent coverage, and only 1 had flap loss.

Conclusion The propeller-flap technique to cover lesions in the lower limb proved to be a good alternative in most cases evaluated, with a good surgical result, although complications were observed in some cases.

Keywords

soft tissue injuries - perforator flap - lower extremity

* Work developed at the Department of Orthopedics and Traumatology, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brazil.




Publication History

Received: 11 December 2019

Accepted: 15 April 2020

Article published online:
25 September 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Rodrigues BL, Portela AR, Pastore Neto M, Drumond AF. Lesão grave de partes moles decorrente de acidente motociclístico. Rev Med Minas Gerais 2013; 23 (04) 536-539
    Google Scholar
  • 2 Aquino Y. Acidentes no trânsito deixaram mais de 1,6 milhão feridos em 10 anos: seis de cada dez casos graves são de pessoas entre 15 e 39 anos. Empresa Brasil de Comunicação, Brasília, 23 mai 2019, Saúde. Disponível em: [Acesso em: 23 jul 2019] http://agenciabrasil.ebc.com.br/saude/noticia/2019-05/acidentes-no-transito-deixaram-mais-de-16-milhao-feridos-em-10-anos
    Google Scholar
  • 3 Andrade SM, Jorge MH. Características das vítimas por acidentes de transporte terrestre em município da Região Sul do Brasil. Rev Saude Publica 2000; 34 (02) 149-156
    CrossrefPubMedGoogle Scholar
  • 4 Koizumi MS. Padrão das lesões nas vítimas de acidentes de motocicleta. Rev Saude Publica 1992; 26 (05) 306-315
    CrossrefPubMedGoogle Scholar
  • 5 Saad FT, Almeida KG, Almeida PY. et al. Reconstrução de dorso do pé com retalho supramaleolar lateral de fluxo reverso em menor de 4 anos de idade. Rev Bras Cir Plást 2015; 30 (02) 324-332
    Google Scholar
  • 6 Chang AJ, Milcheski DA, Nakamoto H, Tuma Junior P, Lobato R, Ferreira MC. Condutas em traumas complexos de partes moles de membros inferiores no HCFMUSP. Rev Bras Cir Plást 2013; 28 (3, Suppl) 1-103
    CrossrefGoogle Scholar
  • 7 Macedo JL, Rosa SC, Silva AA, Filho Neto AVR, Ruguê PH, Scartazzini C. Versatilidade do uso do retalho do músculo gastrocnêmio medial na reconstrução de lesões de partes moles de membros inferiores. Rev Bras Cir Plást 2016; 31 (04) 527-533
    Google Scholar
  • 8 Teixeira Neto N, Chi A, Paggiaro AO, Ferreira MC. Tratamento cirúrgico das feridas complexas. Rev Med (São Paulo) 2010; 89 (3/4): 147-151
    CrossrefGoogle Scholar
  • 9 Rezende MR, Rabelo NT, Benabou JE. et al. Cobertura do terço distal da perna com retalhos de perfurantes pediculados. Acta Ortop Bras 2008; 16 (04) 223-229
    CrossrefGoogle Scholar
  • 10 Sisti A, D'Aniello C, Fortezza L. et al. Propeller Flaps: A Literature Review. In Vivo 2016; 30 (04) 351-373
    PubMedGoogle Scholar
  • 11 DETRAN. Departamento estadual de trânsito. Estatísticas. Disponível em: [Acesso em: 14 jul 2019] http://inside.detran.go.gov.br/acidente/index.htm
  • 12 Sado JM, Morais FD, Viana FP. Caracterização das vítimas por acidentes motociclísticos internados no hospital de urgências de Goiânia. Rev Movimenta 2009; 2 (02) 49-53
    Google Scholar
  • 13 Shen L, Liu Y, Zhang C. et al. Peroneal perforator pedicle propeller flap for lower leg soft tissue defect reconstruction: Clinical applications and treatment of venous congestion. J Int Med Res 2017; 45 (03) 1074-1089
    CrossrefPubMedGoogle Scholar
  • 14 Mendieta M, Cabrera R, Siu A, Altamirano R, Gutierrez S. Perforator Propeller Flaps for the Coverage of Middle and Distal Leg Soft-tissue Defects. Plast Reconstr Surg Glob Open 2018; 6 (05) e1759
    CrossrefPubMedGoogle Scholar
  • 15 Debieux P, Chertman C, Mansur NS, Dobashi E, Fernandes HJ. Lesões do aparelho locomotor nos acidentes com motocicleta. Acta Ortop Bras 2010; 18 (06) 353-356
    CrossrefGoogle Scholar
  • 16 Sasidaran R, Zain MA, Basiron NH, Ajik S. Propeller flaps in lower limb reconstruction: case series. Anaplastology 2013; 3 (01) 1-4
    Google Scholar
  • 17 Bajantri B, Bharathi RR, Sabapathy SR. Wound coverage considerations for defects of the lower third of the leg. Indian J Plast Surg 2012; 45 (02) 283-290
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 D'Arpa S, Toia F, Pirrello R, Moschella F, Cordova A. Propeller flaps: a review of indications, technique, and results. BioMed Res Int 2014; 2014: 986829
    CrossrefPubMedGoogle Scholar
  • 19 Nelson JA, Fischer JP, Brazio PS, Kovach SJ, Rosson GD, Rad AN. A review of propeller flaps for distal lower extremity soft tissue reconstruction: Is flap loss too high?. Microsurgery 2013; 33 (07) 578-586
    CrossrefPubMedGoogle Scholar