Our Definition of Propeller Flaps and Their Classification.

The term was introduced for the first time by Hyakusoku to define an island flap, based on a subcutaneous pedicle hub, that was rotated 90 degrees to correct scar contractures due to burns. With the popularization of perforator flaps, the propeller movement was applied for the first time to a skin island vascularized only by an isolated perforator, and the terms and were used together. Thereafter, the surgical technique of propeller flaps evolved and new applications developed.

Reconstruction of elbow skin and soft tissue defects using perforator-pedicled propeller flaps.

Background: The elbow is a challenging region to reconstruct functionally. Several closure methods for elbow wounds have been reported, including flap surgery. Here, we present the results obtained using a propeller flap pedicled by a posterior ulnar recurrence artery perforator (PURAP) or a radial collateral artery perforator (RCAP) for functional reconstruction of soft tissue defects in elbows.

Combining the external fixation and microsurgical osteoseptocutaneous flap transplantation methods for limb salvage.

Background: The correction of large area limb defects that are the result of congenital abnormalities, traumatic injury, inflammation, or tumors is a challenging task for clinicians. The need to restore the physical, mechanical, and cosmetic aspects of the limb results in a difficult balancing act between deformity repair and tissue reconstruction, between the soft tissue and bone reconstructions, and between the physical, mechanical, and esthetic restorations.

Methods: Between 2003 and 2011, 59 patients with large area limb defects underwent 1- or 2-stage reconstructions that combined external fixation with microsurgical osteocutaneous flap transfer.

Reconstruction of soft tissue defects in the extremities with a pedicled perforator flap: series of 25 patients.

Since the introduction of perforator-based flaps, new flaps have been described for reconstruction of soft tissue defects in the extremities. Pedicled perforator flaps, often called propeller flaps, are based on a single perforator and are local axial flaps that can be rotated up to 180(0) with the single perforator as the pivotal point. Pedicle perforator flaps have gained popularity because they have a shorter operating time than free flaps.

The "Tokyo" consensus on propeller flaps.

Background: Over the past few years, the use of propeller flaps, which base their blood supply on subcutaneous tissue or isolated perforators, has become increasingly popular. Because no consensus has yet been reached on terminology and nomenclature of the propeller flap, different and confusing uses of the term can be found in the literature.

Methods: In this article, the authors report the consensus on the definition and classification of propeller flaps reached by the authors that gathered at the First Tokyo Meeting on Perforator and Propeller Flaps in June of 2009.

Analysis of 22 posterior ulnar recurrent artery perforator flaps: a type of proximal ulnar perforator flap.

Background: The proximal ulnar artery has several branches, including perforators that are directly derived from the ulnar artery and anterior/posterior recurrent arteries. There are only a few reports of flaps that use the anterior/posterior recurrent arteries, and flaps employing their perforators as a main pedicle are yet to be reported. In this study, posterior ulnar recurrent artery perforator (PURAP) flaps were employed for elbow and forearm reconstruction.

Shape-modified radial artery perforator flap method: analysis of 112 cases.

Background: To overcome the donor-site morbidity associated with radial forearm flaps, many modifications of this technique have been reported, including the development of the perforator flap method. In this article, the authors analyze the efficacy of their shape-modified radial artery perforator flap method.

Methods: The authors analyzed all of their 112 cases of reconstruction with the shape-modified method with regard to the cause of injury, recipient site, whether the flap was free or pedicled, flap size, number of components that were divided by perforators, flap survival, and quality of the outcome.

Two-stage reconstruction in congenital pseudarthrosis of the forearm using the Ilizarov technique and vascularized osteoseptocutaneous fibula.

The authors present nine patients with congenital pseudarthrosis of the forearm. The reconstruction was carried out in two stages. At the first stage, Ilizarov's device was applied to the forearm in order to lengthen the affected extremity and to eliminate deformity.

Shape-modified method using the radial forearm perforator flap for reconstruction of soft-tissue defects of the scalp.

The authors present their clinical experience in reconstruction of soft-tissue defects of the scalp in 17 patients, using free radial forearm perforator flaps. These defects, as a rule, have a circular or elliptical shape. In order to fit this shape of the defect, they divided the radial forearm perforator flap into two or three components in each case.

Reconstruction of soft tissue defects of the hand using the shape-modified radial forearm flap.

We have reconstructed soft tissue defects in 121 hands with radial forearm flaps. So that the flap perfectly fitted the defect, and to minimise the size of the donor site, we divided the flap into two or three components in each case. We call this the shape-modified radial forearm flap.