Local perforator flap for reconstruction of deep tissue defects in the elbow area.

Limited deep tissue defects in the elbow area can occur after burns, advanced bursitis, and inflammatory processes, to name a few. Reconstruction is complicated because sufficient tissue with adequate elasticity and strength has to be transferred. Often major surgical procedures such as free tissue transfer are considered. A novel method for reconstruction of deep tissue defects in the elbow area, based on a single perforator artery and vein, is described. Perforator vessels are identified preoperatively using color Doppler ultrasonography, and a flap from the upper arm is rotated 180 degrees. The authors describe the successful treatment of two patients. The surgical technique is comparatively simple and can be performed with regional anesthesia. Postoperative recovery is short and skin sensibility is retained. The authors suggest that local, single perforator flaps can be considered as a first alternative in treatment of limited, deep tissue defects in the elbow area, especially for elderly or severely ill patients.