{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:13:13Z","timestamp":1792462393707,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T00:00:00Z","timestamp":1651017600000},"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":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lower extremity defects have been and remain one of the greatest challenges in reconstructive surgery. Perforator flaps have been accepted as a valid procedure to cover such a defect. Different techniques have been described and nowadays many options are available. However, there were not studies that comprehensively review the most modern techniques and clinical application of the use of perforator flaps in the lower extremity reconstruction. In the present report, we gathered most of them, presenting an updated and large case series where different pedicled and free perforators flaps were employed in simple and complex scenarios in a large series of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Eighty\u2010seven patients presenting soft tissue defects of the lower extremities were treated by means of different perforator\u2010based flaps, in either free or pedicled fashion. The flaps were base<jats:bold>d<\/jats:bold> on different perforator vessels, namely deep lateral circumflex femoral artery, profunda femoris artery, superficial femoral artery, medial sural artery, peroneal artery, posterior tibial artery, anterior tibial artery, and medial plantar artery. Patients' mean age was 61.9\u2009years old (range 21\u201487\u2009years old), 58 were males and 29 females. The 12 patients received sequential flaps and 9 received double free flaps, for a total sum of 106 flaps. The causes of the defects were trauma in 41 patients and tumors in 46 patients, located throughout the lower limbs. Size of the defect ranged from 3\u00a0cm\u2009\u00d7\u20094\u00a0cm to 25\u2009cm\u2009\u00d7\u20099\u00a0cm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The dimensions of the flap skin paddles ranged from 3\u00a0cm\u2009\u00d7\u20094\u00a0cm to 16\u2009cm\u2009\u00d7\u20095\u00a0cm for the pedicled flaps (42 cases) and from 6\u00a0cm\u2009\u00d7\u20094\u00a0cm to 25\u2009cm\u2009\u00d7\u20098\u00a0cm for the free ones (45 cases). Mean flap's size was 48\u2009cm<jats:sup>2<\/jats:sup> (range 12\u201380\u2009cm<jats:sup>2<\/jats:sup>) for the pedicle flaps and 104\u2009cm<jats:sup>2<\/jats:sup> (range 24\u2014200\u2009cm<jats:sup>2<\/jats:sup>) for free flaps. In two pedicled cases, a distal congestion was encountered, requiring a second surgery. Debulking procedures were performed in 2 patients. All the patients were successfully treated and no flaps were lost. Mean follow\u2010up period was 8.4\u00a0months (range 3\u201312\u2009months). No range of motion impairment was encountered after surgery and all the patients were able to return to habitual life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present case series highlights the reliability and versatility of perforator flaps for lower extremity defect coverage. Following careful consideration of the etiology, dimensions, location, patient comorbidities, and presence of adequate perforators, a pedicled or free perforator flap can be potentially successful in the most disparate circumstances.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30892","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T11:30:35Z","timestamp":1651059035000},"page":"548-556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Versatility of perforator flaps for lower extremity defect coverage: Technical highlights and single center experience with 87 consecutive cases"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5289-9140","authenticated-orcid":false,"given":"Mario F.","family":"Scaglioni","sequence":"first","affiliation":[{"name":"Depatment of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital  Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Meroni","sequence":"additional","affiliation":[{"name":"Depatment of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital  Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Knobe","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery Luzerner Kantonsspital  Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar","family":"Fritsche","sequence":"additional","affiliation":[{"name":"Depatment of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital  Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2018.00023"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-0358.101299"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182a4d626"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004124"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.02.031"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30553"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1315786"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200109150-00036"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181ac4263"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181ac4263"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199603000-00007"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e318153f27e"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyz101"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-019-02363-0"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000095948.03605.20"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2010.06.009"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.10.045"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-941720"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1606536"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2005.10.024"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000204959.18136.36"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001228"},{"issue":"5","key":"e_1_2_7_24_1","first-page":"1311","article-title":"Functional outcomes of posttraumatic lower limb salvage: A pilot study of anterolateral thigh perforator flaps versus muscle flaps","volume":"66","author":"Rodriguez E. D.","year":"2009","journal-title":"The Journal of Trauma"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/230949900901700307"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30044"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30718"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2020.12.025"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26228"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1601422"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2014.08.047"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(03)00034-8"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813497923"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000224304.56885.c2"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30734"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30892","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.30892","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30892","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T10:16:29Z","timestamp":1692785789000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.30892"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,27]]},"references-count":34,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1002\/micr.30892"],"URL":"https:\/\/doi.org\/10.1002\/micr.30892","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,27]]},"assertion":[{"value":"2021-09-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}