@article{JakubietzJakubietzHorchetal.2019,
  author    = {Jakubietz, Rafael G. and Jakubietz, Danni F. and Horch, Raymund E. and Gruenert, Joerg G. and Meffert, Rainer H. and Jakubietz, Michael G.},
  title     = {The microvascular peroneal artery perforator flap as a "lifeboat" for pedicled flaps},
  series = {Plastic and Reconstructive Surgery - Global Open},
  volume    = {7},
  journal   = {Plastic and Reconstructive Surgery - Global Open},
  number    = {9},
  doi       = {10.1097/GOX.0000000000002396},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-202233},
  pages     = {e2396},
  year      = {2019},
  abstract  = {Background: Pedicled perforator flaps have expanded reconstructive options in extremity reconstruction. Despite preoperative mapping, intraoperative findings may require microvascular tissue transfer when no adequate perforators can be found. The free peroneal artery perforator flap may serve as a reliable back-up plan in small defects. Methods: In 16 patients with small soft tissue defects on the upper and lower extremities, perforator-based propeller flaps were planned. The handheld Doppler device was used to localize potential perforators for a propeller flap in close proximity to the defect. Perforators of the proximal peroneal artery were also marked to allow conversion to microvascular tissue transfer. Results: In 6 cases, no adequate perforators were found intraoperatively. In 4 patients, the peroneal artery perforator flap was harvested and transferred. The pedicle length did not exceed 4 cm. No flap loss occurred. Conclusions: When no adequate perforator capable of nourishing a propeller flap can be found intraoperatively, the free peroneal artery flap is a good option to reconstruct small soft tissue defects in the distal extremities. The short vascular pedicle is less ideal in cases with a large zone of injury requiring a more distant site of anastomosis or when recipient vessels are located in deeper tissue planes.},
  language  = {en}
}
@article{JakubietzSchmidtBernuthetal.2019,
  author    = {Jakubietz, Rafael G. and Schmidt, Karsten and Bernuth, Silvia and Meffert, Rainer H. and Jakubietz, Michael G.},
  title     = {Evaluation of the intraoperative blood flow of pedicled perforator flaps using indocyanine green-fluorescence angiography},
  series = {Plastic and Reconstructive Surgery - Global Open},
  volume    = {7},
  journal   = {Plastic and Reconstructive Surgery - Global Open},
  number    = {9},
  doi       = {10.1097/GOX.0000000000002462},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-202625},
  pages     = {e2462},
  year      = {2019},
  abstract  = {Background: Although indocyanine-green fluorescence angiography (ICG-FA) has been established as a useful tool to assess perfusion in free tissue transfer, only few studies have applied this modality to pedicled perforator flaps. As both volume and reach of pedicled perforator flaps are limited and tip necrosis often equals complete flap failure, ICG-FA may help to detect hypoperfusion in pedicled flaps. Methods: In 5 patients, soft tissue reconstruction was achieved with pedicled perforator flaps. ICG-FA was utilized intraoperatively to visualize flap perfusion. Results: Three pedicled anterolateral thigh flap flaps and 2 propeller flaps were transferred. ICG-FA detected hypoperfusion in 2 flaps. No flap loss occurred; in 2 cases, prolonged wound healing was encountered. Conclusions: ICG-FA confirmed clinical findings and reliably detected tissue areas with hypoperfusion. A clear cut-off point between nonvital tissue and such that stabilized in the following clinical course could not be found. ICG-FA is a promising technology which could also be used in pedicled perforator flaps.},
  language  = {en}
}