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Abstract：
Soft tissue management in lower limb poses a considerable challenge to a reconstructive plastic surgeon. Perforator-based propeller flaps can cover large wounds without sacrificing a major vascular axis and allows reconstruction using nearby similar tissues, thereby following the principle of replace like with like. This study was undertaken with the objective to look for the results of propeller flap in lower limb reconstruction and how the results can be improved. This was a retrospective study on 40 patients who underwent the reconstruction of soft tissue defects of lower limb with propeller flap. All the relevant data were collected and analyzed. Patients with soft tissue defect anywhere in the leg were included, but patients who had history of degloving injury, peripheral vascular disease, and diabetes mellitus were excluded. All these patients were divided in 2 groups according to the angle of rotation of propeller flap. Group I had 20 patients in which the flap was rotated by 150° to 180°. Group II had 20 patients, and the flap was rotated by 90° to 150°. Postoperatively, the first 2 cases in Group I showed total flap congestion and had complete necrosis, which were debrided and an alternate method was used to reconstruct. Thereafter, no patient had total flap necrosis. Minor complications were seen in 3 patients who showed transient venous congestion of the flap. Group II had no flap necrosis except for mild dehiscence, which was managed by secondary suturing. In most cases, the aesthetic result was acceptable and patients were completely satisfied. When parameters of the defect are suitable for treatment with a propeller-based local flap, this technique may be considered as the first option for surgical reconstruction. Proper planning, location of perforator with preoperative and intraoperative audio Doppler, and use of magnification would make this procedure more successful and definitely decrease the use of long-duration microvascular surgery.
摘要：
下肢软组织管理对重建整形外科医生提出了相当大的挑战。基于穿孔器的螺旋桨皮瓣可以覆盖大伤口而不牺牲主要血管轴，并允许使用附近的类似组织进行重建，从而遵循用喜欢代替喜欢的原则。进行这项研究的目的是寻找螺旋桨皮瓣在下肢重建中的结果以及如何改善结果。本文对40例应用螺旋桨瓣修复下肢软组织缺损的患者进行了回顾性研究。收集并分析所有相关数据。包括腿部任何部位软组织缺损的患者，但是有脱套伤病史的病人,外周血管疾病,排除糖尿病。根据螺旋桨瓣的旋转角度将所有患者分为2组。第一组有20例患者，其中皮瓣旋转150°至180°。第二组有20名患者，襟翼旋转90°至150°。术后,第一组的前2例表现为皮瓣完全充血和完全坏死，进行了清创，并使用了另一种方法来重建。此后,无患者出现皮瓣完全坏死。在3例显示皮瓣短暂静脉充血的患者中发现了轻微的并发症。II组除轻度裂开外,无皮瓣坏死,这是通过二次缝合管理。在大多数情况下,美学效果可接受，患者完全满意。当缺损的参数适合使用基于螺旋桨的局部皮瓣治疗时，该技术可被视为手术重建的首选方案.正确的规划,术前和术中音频多普勒的穿支位置，和使用放大将使该手术更成功，并且绝对减少了长时间微血管手术的使用。
