-Case Reports-

The Perforator Pedicled Propeller (PPP) Flap Method: A Report of Two Cases

Hiko Hyakusoku, Rei Ogawa, Koichiro Oki and Nobuaki Ishii

Department of Plastic, Reconstructive and Regenerative Surgery, Graduate School of Medicine, Nippon Medical School

Background: Perforator flaps are thin free-tissue transfers consisting of skin and subcutaneous tissue which have the advantage of decreasing donor site morbidity. We have reconstructed postburn scar contractures using "propeller flaps" of the remaining healthy skin around the recipient sites. In this paper, we report on two cases and describe the concept of using "perforator flaps" and "propeller flaps" together as what are called "perforator pedicled propeller (PPP) flaps."
Cases: Patient 1 was an 18-year-old man with a sacral pressure ulcer. The soft tissue defect was reconstructed with a rotated superior gluteal artery PPP flap. Patient 2 was a 53-year-old woman who presented with an open fracture of the right elbow. The skin defect over the fracture was covered with a rotated deep brachial artery PPP flap raised on the lateral upper arm.
Conclusion: The PPP flaps are useful for burn reconstruction and repairing various types of wound. Moreover, microsurgery is unnecessary. The PPP flap may be classified into two types: the central axis type and the acentric axis type. The central axis PPP flap is significant when used as a 90-degree-rotation island flap, and the acentric axis PPP flap is significant when used as a 180-degree-rotation island flap. Both types are easy to harvest and useful for repairing various kinds of wound.

J Nippon Med Sch 2007; 74: 367-371

Keywords
propeller flap, perforator flap, free flap

Correspondence to
Rei Ogawa, MD, PhD, Department of Plastic and Reconstructive Surgery, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo 113-8603, Japan
r.ogawa@nms.ac.jp

Received, March 1, 2007
Accepted, June 27, 2007