The Preoperative Planning, Design, and Execution of the Freestyle Propeller Flap: A Detailed Description and the Case Series
Case series published in Arch Plast Surg (2025)
Abstract
BACKGROUND: Propeller flap reconstruction has been widely utilized in soft tissue reconstruction due to its versatility and aesthetic outcomes. However, technical challenges and the risk of complications persist. This study aims to provide detailed guidelines on the preoperative planning, intraoperative considerations, and execution of propeller flap surgery to reduce complications. METHODS: A retrospective review was conducted on 20 consecutive patients undergoing propeller flap reconstruction between January 2018 and December 2020. Preoperative planning involved computed tomography (CT) angiography and color Doppler ultrasound. Flap designs prioritized perforator proximity (<3 cm from the defect), vessel axiality, and tissue laxity assessed by skin pinch tests. Surgical techniques including pedicle skeletonization, flap elevation, rotation, and inset were meticulously followed. RESULTS: No total flap loss occurred. Partial flap loss was observed in one case (5%). Two flaps (10%) exhibited venous congestion, which resolved following leech therapy without necrosis. Defects were predominantly located on the trunk (80%), with malignancy as the primary cause (55%). Mean follow-up duration was 432 days. CONCLUSIONS: Careful preoperative planning and adherence to meticulous surgical techniques can significantly reduce complications in propeller flap reconstruction. This structured approach offers a reliable framework, particularly beneficial for surgeons less familiar with propeller flap techniques.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Retrospective series of 20 propeller-flap reconstructions with two cases of venous congestion (10%) resolved by leech therapy without necrosis. Documents preoperative planning and surgical technique guidelines.
Por qué esto importa para la hirudoterapia
Este artículo reporta una serie de casos de 20 pacientes consecutivos sometidos a reconstrucción con colgajo en hélice entre enero de 2018 y diciembre de 2020, detallando la planificación preoperatoria con angio-TC y ecografía Doppler color, las técnicas quirúrgicas y los desenlaces, que incluyen ausencia de pérdida total del colgajo, una pérdida parcial del colgajo (5 %) y dos casos de congestión venosa (10 %) que se resolvieron tras la hirudoterapia sin necrosis. Para el ámbito de ASH, esto demuestra la hirudoterapia como medida práctica de rescate frente a la congestión venosa en cirugía de colgajos, con desenlaces exitosos en los casos reportados. El resumen no aporta detalles sobre la especie de sanguijuela, el protocolo, la duración ni las complicaciones específicamente atribuibles a la hirudoterapia. La mención de la hirudoterapia es incidental al foco principal de planificación y ejecución quirúrgica, y el tamaño muestral de los casos tratados con sanguijuelas es de solo dos pacientes.
Citación
The Preoperative Planning, Design, and Execution of the Freestyle Propeller Flap: A Detailed Description and the Case Series.
Kim HB et al. · Archives of plastic surgery, 2025
Contexto clínico relacionado
Explore cómo esta investigación se conecta con la práctica clínica
Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026