{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:46:06Z","timestamp":1790786766345,"version":"4.1.0"},"reference-count":42,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Plast Surg"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The term propeller flap was introduced for the first time by Hyakusoku to define an island flap, based on a subcutaneous pedicle hub, that was rotated 90\u2009degrees to correct scar contractures due to burns. With the popularization of perforator flaps, the propeller movement was applied for the first time to a skin island vascularized only by an isolated perforator, and the terms propeller and perforator flap were used together. Thereafter, the surgical technique of propeller flaps evolved and new applications developed. With the \u201cTokyo consensus,\u201d we proposed a definition and a classification schema for propeller flaps. A propeller flap was defined as an \u201cisland flap that reaches the recipient site through an axial rotation.\u201d The classification included the SPP (SPP) flap, the perforator pedicled propeller (PPP) flap, and the supercharged PPP (SCP) flap. A recent update added a new category, the axial pedicled propeller (APP) flap. Here we propose our updated and comprehensive classification of propeller flaps, taking into account the previous classification and subsequent publications. Based on their vascular pedicle, we consider the following five types of propellers: (1) SPP flap, 2.PPP flap, its subtype (2a) SCP flap, (3) APP flap, (4) muscle propeller flap, and (5) chimeric propeller flap. The variables that can be taken into account in the classification are as follows: type of nourishing pedicle, degrees of skin island rotation, position of the nourishing pedicle, artery of origin of the pedicle, and flap shape.<\/jats:p>","DOI":"10.1055\/s-0040-1715158","type":"journal-article","created":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T22:42:23Z","timestamp":1600814543000},"page":"139-144","source":"Crossref","is-referenced-by-count":22,"title":["Our Definition of Propeller Flaps and Their Classification"],"prefix":"10.1055","volume":"34","author":[{"given":"Marco","family":"Pignatti","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Policlinico di Sant'Orsola - DIMES, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rei","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Mateev","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru V.","family":"Georgescu","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Reconstructive Microsurgery, Clinical Hospital of Rehabilitation, University of Medicine Iuliu Hatieganu, Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govindasamy","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Plastic, Hand & Microvascular Surgery, Right Hospitals, Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimpei","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Cubison","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Policlinico di Sant'Orsola - DIMES, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"D'Arpa","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgical, Oncological, and Oral Sciences (DICHIORONS), University of Palermo, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isao","family":"Koshima","sequence":"additional","affiliation":[{"name":"International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiko","family":"Hyakusoku","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey G.","family":"Hallock","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Sacred Heart Campus, St. Luke's Hospital, Allentown, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,9,22]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/0007-1226(91)90179-N","article-title":"The propeller flap method","volume":"44","author":"H Hyakusoku","year":"1991","journal-title":"Br J Plast Surg"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/0007-1226(87)90185-8","article-title":"The vascular territories (angiosomes) of the body: experimental study and clinical applications","volume":"40","author":"G I Taylor","year":"1987","journal-title":"Br J Plast Surg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S0094-1298(03)00034-8","article-title":"The angiosomes of the body and their supply to perforator flaps","volume":"30","author":"G I Taylor","year":"2003","journal-title":"Clin Plast Surg"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/00006534-199809010-00001","article-title":"Angiosomes of the leg: anatomic study and clinical implications","volume":"102","author":"G I Taylor","year":"1998","journal-title":"Plast Reconstr Surg"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1097\/01.PRS.0000081071.83805.B6","article-title":"The \u201cGent\u201d consensus on perforator flap terminology: preliminary definitions","volume":"112","author":"P N Blondeel","year":"2003","journal-title":"Plast Reconstr Surg"},{"key":"ref6","first-page":"1245","volume-title":"Free-style free flaps","author":"S Mardini","year":"2013"},{"issue":"01","key":"ref7","first-page":"58","article-title":"Lambeau radial antibrachial en \u00eelot bas\u00e9 sur des perforantes distales. A propos d'un cas clinique","volume":"45","author":"A V Georgescu","year":"2000","journal-title":"Ann Chir Plast Esthet"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1097\/01.sap.0000210512.81988.2b","article-title":"The propeller flap version of the adductor muscle perforator flap for coverage of ischial or trochanteric pressure sores","volume":"56","author":"G G Hallock","year":"2006","journal-title":"Ann Plast Surg"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.cps.2010.06.003","article-title":"The propeller flap concept","volume":"37","author":"T C Teo","year":"2010","journal-title":"Clin Plast Surg"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1097\/01.sap.0000239841.47088.a5","article-title":"Our experience in lower limb reconstruction with perforator flaps","volume":"58","author":"J Masia","year":"2007","journal-title":"Ann Plast Surg"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1097\/SAP.0b013e31803c9b66","article-title":"The 180-degree perforator-based propeller flap for soft tissue coverage of the distal, lower extremity: a new method to achieve reliable coverage of the distal lower extremity with a local, fasciocutaneous perforator flap","volume":"59","author":"R G Jakubietz","year":"2007","journal-title":"Ann Plast Surg"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.bjps.2007.10.077","article-title":"Propeller flaps for leg reconstruction","volume":"61","author":"M Pignatti","year":"2008","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/BTO.0b013e3181b37681","article-title":"Novel fasciocutaneous flaps for the reconstruction of complicated lower extremity wounds","volume":"24","author":"M Pignatti","year":"2009","journal-title":"Tech Orthop"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"986829","DOI":"10.1155\/2014\/986829","article-title":"Propeller flaps: a review of indications, technique, and results","volume":"2014","author":"S D'Arpa","year":"2014","journal-title":"BioMed Res Int"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1097\/PRS.0b013e3182268c83","article-title":"Freestyle pedicled perforator flaps: safety, prevention of complications, and management based on 85 consecutive cases","volume":"128","author":"S D'Arpa","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1002\/micr.20376","article-title":"Microsurgical nonmicrovascular flaps in forearm and hand reconstruction","volume":"27","author":"A V Georgescu","year":"2007","journal-title":"Microsurgery"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1097\/PRS.0b013e3181a07655","article-title":"Shape-modified radial artery perforator flap method: analysis of 112 cases","volume":"123","author":"M A Mateev","year":"2009","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"65e","DOI":"10.1097\/PRS.0b013e318195955d","article-title":"One-stage reconstruction of the nasal ala: the free-style nasolabial perforator flap","volume":"123","author":"S D'Arpa","year":"2009","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1055\/s-0034-1376877","article-title":"A propeller flap for single-stage nose reconstruction in selected patients: supratrochlear artery axial propeller flap","volume":"30","author":"A Cordova","year":"2014","journal-title":"Facial Plast Surg"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1055\/s-0034-1376873","article-title":"Reconstruction of nasal alar defects with freestyle facial artery perforator flaps","volume":"30","author":"S D'Arpa","year":"2014","journal-title":"Facial Plast Surg"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"571e","DOI":"10.1097\/PRS.0b013e3182419bc4","article-title":"A new one-stage method for nose reconstruction: the supratrochlear artery perforator propeller flap","volume":"129","author":"A Cordova","year":"2012","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.bjps.2008.06.057","article-title":"Free style facial artery perforator flap for one stage reconstruction of the nasal ala","volume":"62","author":"S D'Arpa","year":"2009","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/01.prs.0000220880.28359.86","article-title":"Clinical and anatomical study of superficial cervical artery flaps: retrospective study of reconstructions with 41 flaps and the feasibility of harvesting them as perforator flaps","volume":"118","author":"R Ogawa","year":"2006","journal-title":"Plast Reconstr Surg"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"204","DOI":"10.20517\/2347-9264.2017.33","article-title":"Current applications of propeller aps in reconstruction of trunk wounds","volume":"4","author":"S Moshre","year":"2017","journal-title":"Plast Aesthet Res"},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1097\/PRS.0b013e3181fed6b2","article-title":"The \u201cTokyo\u201d consensus on propeller flaps","volume":"127","author":"M Pignatti","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"06","key":"ref26","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.bjps.2017.02.007","article-title":"Axial propeller flaps: a proposal for update of the \u201cTokyo consensus on propeller flaps\u201d","volume":"70","author":"F Toia","year":"2017","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"02","key":"ref27","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.anplas.2010.11.004","article-title":"Propeller flaps: classification and clinical applications","volume":"56","author":"B Ayestaray","year":"2011","journal-title":"Ann Chir Plast Esthet"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/01.prs.0000175224.86714.05","article-title":"The multilobed propeller flap method","volume":"116","author":"M Murakami","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s41038-017-0079-7","article-title":"A review and critical appraisal of central axis flaps in axillary and elbow contractures","volume":"5","author":"D Karki","year":"2017","journal-title":"Burns Trauma"},{"issue":"06","key":"ref30","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1097\/SAP.0000000000002076","article-title":"\u201cNamaste flap\u201d: modification of subcutaneous pedicle propeller flaps in the reconstruction of postburn axillary and elbow contractures","volume":"83","author":"D Karki","year":"2019","journal-title":"Ann Plast Surg"},{"issue":"08","key":"ref31","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0007-1226(96)90132-0","article-title":"Lotus petal flaps in vulvo-vaginal reconstruction","volume":"49","author":"N W Yii","year":"1996","journal-title":"Br J Plast Surg"},{"issue":"12","key":"ref32","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1002\/ccr3.2492","article-title":"Reconstruction of a deep sternal wound with exposed pericardium using an IMAP propeller flap: a case report","volume":"7","author":"F Zanchetta","year":"2019","journal-title":"Clin Case Rep"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1002\/micr.30544","article-title":"Reconstruction of a large pelvic defect by transfer of a quadruplet combination of pedicled flaps from the medial thigh using bilateral muscular gracilis flaps and bilateral vertical posteromedial thigh (vPMT) propeller flaps-a case report","volume":"40","author":"K T Wishart","year":"2020","journal-title":"Microsurgery"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/01.GOX.0000503018.73352.af","article-title":"Abstract: Obturator artery perforator propeller flap for scrotal and vulvar reconstruction","volume":"4","author":"M H Cheng","year":"2016","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"03","key":"ref35","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0094-1298(03)00035-X","article-title":"Perforator flap terminology: update 2002","volume":"30","author":"P N Blondeel","year":"2003","journal-title":"Clin Plast Surg"},{"issue":"02","key":"ref36","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1002\/micr.30162","article-title":"Comparison of propeller perforator flap and venous supercharged propeller perforator flap in reconstruction of lower limb soft tissue defect: a prospective study","volume":"38","author":"B Chaput","year":"2018","journal-title":"Microsurgery"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1055\/s-0035-1570533","article-title":"Prophylactic venous supercharged radial collateral artery perforator propeller flap: improved outcome in perforator propeller flaps","volume":"1","author":"D Kosutic","year":"2016","journal-title":"J Reconstr Microsurg Open"},{"issue":"03","key":"ref38","doi-asserted-by":"crossref","first-page":"584e","DOI":"10.1097\/PRS.0000000000000956","article-title":"A new mucosal propeller flap (deep lingual artery axial propeller): the renaissance of lingual flaps","volume":"135","author":"A Cordova","year":"2015","journal-title":"Plast Reconstr Surg"},{"issue":"05","key":"ref39","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1002\/micr.30395","article-title":"A new propeller trapezius muscle flap for reconstruction of posterior trunk defects: an anatomic study and report of three cases","volume":"39","author":"J Meyerson","year":"2019","journal-title":"Microsurgery"},{"issue":"01","key":"ref40","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1055\/s-2002-19706","article-title":"Combined latissimus dorsi-thoracodorsal artery perforator free flap: the \u201crazor flap.\u201d","volume":"18","author":"P C Cavadas","year":"2002","journal-title":"J Reconstr Microsurg"},{"issue":"03","key":"ref41","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1055\/s-0040-1714290","article-title":"The chimeric propeller flap","volume":"34","author":"G G Hallock","year":"2020","journal-title":"Semin Plast Surg"},{"issue":"03","key":"ref42","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1055\/s-0040-1714271","article-title":"How to design and harvest a propeller flap","volume":"34","author":"M Pignatti","year":"2020","journal-title":"Semin Plast Surg"}],"container-title":["Seminars in Plastic 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