@article{JakubietzSchmidtHolzapfeletal.2020,
  author    = {Jakubietz, Rafael G. and Schmidt, Karsten and Holzapfel, Boris M. and Meffert, Rainer H. and Jakubietz, Michael G.},
  title     = {Pedicled perforator flaps for mid-tibial soft tissue reconstruction in medically compromised patients},
  series = {JPRAS Open},
  volume    = {24},
  journal   = {JPRAS Open},
  doi       = {10.1016/j.jpra.2020.02.002},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229473},
  pages     = {47-55},
  year      = {2020},
  abstract  = {Background: The soft tissue of the central pretibial area is difficult to reconstruct often requiring free tissue transfer. Especially medi- cally compromised patients are not ideal candidates for free tissue transfer and may benefit from expeditiously harvested local flaps with limited donor site morbidity. As muscle flaps are rare, pedi- cled flaps based on lateral perforators represent an alternative as the arc of rotation can often be limited to 90 °. Material and Methods: A retrospective analysis of patient data was conducted to identify patients over the age of 60 years with comor- bidities that underwent pretibial soft tissue reconstruction with a single-pedicle perforator flap. Patient demographics, size and cause of the defect, flap dimension, arc of rotation and complications were recorded. Results: Five patients with an average age of 71.4 years were in- cluded. The arc of rotation was 69 °, all flaps healed. There were two recurrences of osteomyelitis. Conclusion: Lateral perforators originating from the anterior tib- ial artery or peroneal artery are adequate source vessels for single pedicled perforator flaps even in medically compromised patients. A perforator located proximal to the defect allows limiting the arcof rotation to less than 90 °, which increases the safety of the flap. Patients benefit from a simple procedure without a microvascular anastomosis and a donor site confined to one extremity},
  language  = {en}
}