Saul N Rajak1,2, Shyamala C Huilgol3, Masahiro Murakami4, Dinesh Selva5. 1. The Sussex Eye Hospital, Brighton and Sussex University Hospital, Brighton, UK. Saul.rajak@bsuh.nhs.uk. 2. South Australian Institute of Ophthalmology, Royal Adelaide Hospital, North Terrace, Adelaide, SA, Australia. Saul.rajak@bsuh.nhs.uk. 3. Department of Dermatology, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA, 5000, Australia. 4. Department of Plastic and Reconstructive Surgery, Nippon Medical School Musashi-Kosugi Hospital, Tokyo, Japan. 5. South Australian Institute of Ophthalmology, Royal Adelaide Hospital, North Terrace, Adelaide, SA, Australia.
Abstract
PURPOSE: Propeller flaps are island flaps that reach the recipient site through an axial rotation. The flap has a subcutaneous pedicle on which it pivots, thereby resembling a helicopter propeller. We present our series of propeller flaps for the reconstruction of large eyelid defects. METHODS: This is a retrospective review of the clinical case notes of eight patients that underwent tumour excision with reconstruction with a cutaneous propeller flap supplied by a non-perforator orbicularis pedicle between July and December 2016. RESULTS: Propeller flaps were used in the reconstruction of five lower lid defects (size range 19 × 5 mm to 25 × 8 mm), one medial canthus defect (13 mm diameter), one complete upper lid defect (42 × 19 mm diameter) and one lid sparing extenteration defect. The flaps were recruited from nasolabial, lateral canthal, temple or medial upper cheek skin. Post-operatively one case had 'trapdooring' which required flap revision at 4 months and one had persistent oedema that settled without intervention. CONCLUSIONS: The reconstruction of large eyelid defects is challenging in part because of the paucity of locally available skin. Propeller flaps are a paradigm shift in periocular reconstruction in which the subcutaneous pedicle enables the recruitment of large and highly mobile skin flaps from a wide area of regional tissue.
PURPOSE:Propeller flaps are island flaps that reach the recipient site through an axial rotation. The flap has a subcutaneous pedicle on which it pivots, thereby resembling a helicopter propeller. We present our series of propeller flaps for the reconstruction of large eyelid defects. METHODS: This is a retrospective review of the clinical case notes of eight patients that underwent tumour excision with reconstruction with a cutaneous propeller flap supplied by a non-perforator orbicularis pedicle between July and December 2016. RESULTS:Propeller flaps were used in the reconstruction of five lower lid defects (size range 19 × 5 mm to 25 × 8 mm), one medial canthus defect (13 mm diameter), one complete upper lid defect (42 × 19 mm diameter) and one lid sparing extenteration defect. The flaps were recruited from nasolabial, lateral canthal, temple or medial upper cheek skin. Post-operatively one case had 'trapdooring' which required flap revision at 4 months and one had persistent oedema that settled without intervention. CONCLUSIONS: The reconstruction of large eyelid defects is challenging in part because of the paucity of locally available skin. Propeller flaps are a paradigm shift in periocular reconstruction in which the subcutaneous pedicle enables the recruitment of large and highly mobile skin flaps from a wide area of regional tissue.
Authors: Marco Pignatti; Rei Ogawa; Geoffrey G Hallock; Musa Mateev; Alexandru V Georgescu; Govindasamy Balakrishnan; Shimpei Ono; Tania C S Cubison; Salvatore D'Arpa; Isao Koshima; Hikko Hyakusoku Journal: Plast Reconstr Surg Date: 2011-02 Impact factor: 4.730