Dynamic anatomical study of the posterior brachial artery perforator flap: Aesthetic refinement and clinical results.

Background: Reconstruction of the axillary fossa represents a surgical challenge given the functional implications for mobility of the upper limb. The posterior brachial flap is a solution of choice for this indication, providing fine and functional local reconstruction, but little is known about its perforasome. This study aimed to identify the location of the perforator, analyze perfusion flow, and link vessel distribution, and propose an aesthetic refinement to the surgical technique by medializing the skin paddle to conceal aesthetic scarring at the donor site.

Posterior arm perforator flap for coverage of the scapular area.

We report on using a pedicled posterior brachial perforator flap to cover a defect of the infraspinous fossa. The first description of the posterior brachial flap came from Masquelet in 1985, and there are very few reports of this flap in the literature, mainly in its pedicled form limited to axillary covers. Scapular soft tissue defect with bone exposure can be covered by several techniques.

How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs.

Moderate soft-tissue defects need stable coverage, ideally with tissue of similar characteristics and low donor site morbidity. We propose a simple technique for the coverage of moderate skin defects in the limbs. It allows intraoperative transformation of a propeller perforator flap (PPF) into a keystone design perforator flap (KDPF) in cases of unsatisfying perforator vessel or in cases of unpredictable intraoperative events.