Pedicled perforator flap of stellate design.

The perforator flap has proven to be effective as both a free flap and a pedicled flap in the reconstruction of a variety of regions. Usually, a V-Y advancement pattern or simple ellipse is the design selected for pedicled perforator island flaps. On the other hand, the transposition of multiple perforator flaps or skin grafting on the donor sites is required for larger defects. The authors used a stellate design to elevate a perforator flap with large dimensions, whilst allowing the easier closure of the donor defect. This method was used for reconstructing the sacral (six cases), trochanteric (one case), and lower leg (three cases) regions. Although minor wound dehiscence at the donor sites was encountered in three cases, all the defects were reconstructed successfully using a single perforator flap. This design would be a valuable option for planning a pedicled perforator flap, particularly when a difficult donor closure is expected.