Download PDF
CC BY-NC 4.0 · Arch Plast Surg 2019; 46(02): 176-180
DOI: 10.5999/aps.2018.00983
Idea and Innovation

The flip-flap puzzle flap: Another recycling option

Silvia Gandolfi 
Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
,
Raphael Carloni 
Department of Plastic Surgery, Hôpital Privé de l’Estuaire, Le Havre, France
,
Matthieu Gilleron 
Department of Orthopedic Surgery, Charles Nicolle University Hospital, Rouen, France
,
Albane Bonmarchand 
Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
,
Isabelle Auquit-Auckbur 
Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
› Author Affiliations
› Further Information
   Permissions and Reprints

Post-traumatic soft tissue defects sometimes require sequential flap coverage to achieve complete healing. In the era of propeller flaps, which were developed to reduce donor site morbidity, Feng et al. introduced the concept of the free-style puzzle flap, in which a previously harvested flap becomes its own donor site by recycling the perforator. However, when a perforator cannot be found with a Doppler device, we suggest performing a new type of flap, the flip-flap puzzle flap, which combines two concepts: the free-style puzzle flap and the flip-flap flap described by Voche et al. in the 1990s. We present the cases of three patients who achieved complete healing through this procedure.

Keywords

Surgical flaps - Perforator flaps - Reconstructive surgical procedures - Extremities - Soft tissue injuries


Publication History

Received: 23 August 2018

Accepted: 08 December 2018

Article published online:
03 April 2022

© 2019. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • REFERENCES

  • 1 Feng KM, Hsieh CH, Jeng SF. Free-style puzzle flap: the concept of recycling a perforator flap. Plast Reconstr Surg 2013; 131: 258-63
    CrossrefPubMedGoogle Scholar
  • 2 Voche P, Merle M. The homodigital subcutaneous flap for cover of dorsal finger defects. Br J Plast Surg 1994; 47: 435-9
    CrossrefPubMedGoogle Scholar
  • 3 Voche P, Beustes-Stefanelli M. Lambeau sous-dermique homodigital palmaire retourné ou lambeau flip-flap. In: Le Nen D, Hu W, Laulan J. Approche pratique de la couverture des pertes de substance cutanée de la main et des doigts. Paris: Springer; 2007: 161-5
    CrossrefGoogle Scholar
  • 4 Tsur H, Daniller A, Strauch B. Neovascularization of skin flaps: route and timing. Plast Reconstr Surg 1980; 66: 85-90
    CrossrefPubMedGoogle Scholar
  • 5 Chaput B, Eburdery H, Laguerre J. et al. Chimeric flap and free-style puzzle flap for extended coverage of the foot and ankle. Plast Reconstr Surg 2015; 135: 797e-799e
    CrossrefPubMedGoogle Scholar
  • 6 Herlin C, Lievain L, Qassemyar Q. et al. Freestyle free perforator flaps for heel reconstruction. Ann Chir Plast Esthet 2013; 58: 283-9
    CrossrefPubMedGoogle Scholar
  • 7 Maghrabi HE, Grolleau JL, Chavoin JP. Traitement chirurgical des escarres. Techniques chirurgicales - Chirurgie plastique reconstructrice et esthétique 2011; 6: 1-10
    Google Scholar