{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:13:57Z","timestamp":1787872437346,"version":"build-2784847793"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T00:00:00Z","timestamp":1529366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The primary closure of the vertical posteromedial thigh (vPMT) free flap donor site is very important to minimize donor site morbidity and maximize cosmetic appearance. However, sometimes due to the dimension of the defect, a vPMT flap is wider than the 8\u201310 cm requirement. The authors report their experience with the third perforator of the profunda femoris artery (PFA) during the vPMT free flap donor\u2010site closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Between January 2016 and December 2017, 5 patients underwent reconstruction of lower extremity (2 pts.) and head and neck (3 pts.) area with the free vPMT flaps. Attempts to close the vPMT free flap donor site directly failed due to the flaps' width (average: 11 cm) and pedicled perforator flaps based on the third perforator of the PFA at the distal thigh were harvested to close the defect primary without the use of a skin graft. The size of perforator flap based on 3rd perforator of PFA was on average 6 cm \u00d7 4 cm (ranged: 4\u20138 cm \u00d7 3\u20136 cm).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all patients, the third perforator of the PFA was identified and the perforator diameter was on average 2.0 mm (range, 1.8\u20132.2 mm). All perforators were musculocutaneous and single. The dimensions of the flaps were on average 6 cm \u00d7 4 cm (range: 4 to 8 cm \u00d7 3 to 6 cm). All flaps healed uneventfully without complications and the patients were satisfied with cosmetic and functional results at 6 months follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The third perforator of the PFA may be an option to ensure primary closure of the PMT flap donor site, when a larger flap for reconstruction is needed with subsequent impossibility to achieve primary closure of the donor site.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30338","type":"journal-article","created":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T21:44:55Z","timestamp":1529444695000},"page":"758-762","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Perforator flap based on the third perforator of the profunda femoris artery (PFA)\u2010assisted closure of the free vertical posteromedial thigh (vPMT) flap donor site"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5289-9140","authenticated-orcid":false,"given":"Mario F.","family":"Scaglioni","sequence":"first","affiliation":[{"name":"Department of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e8 A.","family":"Barth","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Hand Surgery University Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5792-8334","authenticated-orcid":false,"given":"Yen\u2010Chou","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Body Science &amp; Metabolic Disorders International (BMI) Medical Center, China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2012.05.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182363d9f"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181ef8cb7"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24233"},{"key":"e_1_2_7_6_1","article-title":"The combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for breast reconstruction","author":"Ciudad P.","year":"2015","journal-title":"Microsurgery."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181fed789"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318188205f"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.21980"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.SAP.0000096149.92205.44"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181c495ed"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3182185ee1"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20839"},{"key":"e_1_2_7_14_1","first-page":"381","article-title":"The anatomic basis of the profunda femoris artery perforator flap: A new option for autologous breast reconstruction\u2013a cadaveric and computer tomography angiogram study","volume":"28","author":"Saad A.","year":"2012","journal-title":"Journal of Reconstructive Microsurgery"},{"key":"e_1_2_7_15_1","first-page":"371","article-title":"The vertical posteromedial thigh (vPMT) flap for autologous breast reconstruction: A novel flap design","author":"Scaglioni M. 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