Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Mario F. Scaglioni, Alberto Franchi, Pietro Giovanoli
IntroductionThe posteromedial thigh (PMT) perforator flap is a valuable reconstructive option. In its pedicled form the experience is currently limited to a few case reports. The purpose of this article is to describe various clinical applications of the pedicled posteromedial thigh flap (pPMT) for reconstruction of loco-regional soft tissue defects.Patients and MethodsFrom 2014 to 2016, 15 patients underwent reconstruction with 15 pedicled PMT (pPMT) flaps. The locations of the defects included: the inguinal region (4 cases), the perineal and genital region (3 cases), the proximal and distal medial thigh (3 and 2 cases, respectively) and the popliteal fossa (3 cases). The perforator selected was a branch of the profunda femoris artery (PFA) in 12 cases and the medial circumflex fermoral artery (MCFA) in 3 cases. In all cases the flap was harvested as a perforator-based island flap while the mechanism of flap transfer varied between V-Y advancement, interpolation or different degrees of axial pivoting around the skeletonised perforator (propeller flap design).ResultsThe flap sizes varied from 5 × 4 cm2 to 29 × 8 cm2 and the pedicle could be skeletonised for up to 13 cm. All of the flaps survived after surgery without complication. The donor sites were all primarily closed with minimal morbidity. Follow-up observations were conducted for 6 to 14 months, and all patients had good functional recovery.ConclusionThe pedicled PMT (pPMT) perforator flap is a reconstructive option that can be considered when dealing with soft tissue defects located in body regions ranging from the groin down to the popliteal fossa. It avoids the need for a microsurgical transfer and easily fulfils the dictum of replacing "like tissue with like tissue".
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