PDF(Pubmed)
Abstract：
UNASSIGNED: Propeller perforator flaps (PPFs) have increased in popularity due to the freedom in design and ability to cover a variety of defects without sacrificing the major vessels. Present reports of PPFs for upper limb reconstruction have not provided guidance for hand reconstruction, specifically. This study aims to review the current literature and evaluate techniques for use of PPFs in hand reconstruction.
UNASSIGNED: A comprehensive literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles published from 1991 to 2021. The database search was queried for records using appropriate Medical Subject Headings (MeSH) terms. Studies reporting PPFs were limited to English language and excluded lower extremity or upper extremity reconstruction not specific to defects in the hand or digits. Study characteristics, patient demographics, indications, preoperative testing, flap characteristics, flap survival, and complication rates were collected.
UNASSIGNED: Out of the initial 1,348 citations yielded, 71 underwent full-text review. Ultimately, 25 unique citations were included encompassing 12 retrospective reviews (48%), 3 prospective cohort studies (10%), and 10 case series (40%). In review, 525 patients underwent reconstruction with a total of 613 propeller flaps performed to repair defects of the hand, digits, or both with use of 18 unique flap types. Overall flap survival was 97.8%. Acute wounds accounted for 72.9% of performed reconstructions. The mean flap coverage was 14.7 cm2. Complications occurred in 19.8% of cases, with venous congestion and partial flap necrosis occurring in 5.5 and 6.5% of cases, respectively, leading to a flap failure rate of 2.1%.
UNASSIGNED: PPFs are a reliable option for hand or digital reconstruction, allowing surgeons to cover a variety of defects without sacrificing local vasculature. Despite nearly a 20% reported complication rate, nearly all flaps with venous congestion and partial flap necrosis included in these articles resolved without the need for secondary intervention, retaining an excellent overall flap survival.
UNASSIGNED: A comprehensive literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles published from 1991 to 2021. The database search was queried for records using appropriate Medical Subject Headings (MeSH) terms. Studies reporting PPFs were limited to English language and excluded lower extremity or upper extremity reconstruction not specific to defects in the hand or digits. Study characteristics, patient demographics, indications, preoperative testing, flap characteristics, flap survival, and complication rates were collected.
UNASSIGNED: Out of the initial 1,348 citations yielded, 71 underwent full-text review. Ultimately, 25 unique citations were included encompassing 12 retrospective reviews (48%), 3 prospective cohort studies (10%), and 10 case series (40%). In review, 525 patients underwent reconstruction with a total of 613 propeller flaps performed to repair defects of the hand, digits, or both with use of 18 unique flap types. Overall flap survival was 97.8%. Acute wounds accounted for 72.9% of performed reconstructions. The mean flap coverage was 14.7 cm2. Complications occurred in 19.8% of cases, with venous congestion and partial flap necrosis occurring in 5.5 and 6.5% of cases, respectively, leading to a flap failure rate of 2.1%.
UNASSIGNED: PPFs are a reliable option for hand or digital reconstruction, allowing surgeons to cover a variety of defects without sacrificing local vasculature. Despite nearly a 20% reported complication rate, nearly all flaps with venous congestion and partial flap necrosis included in these articles resolved without the need for secondary intervention, retaining an excellent overall flap survival.
摘要：
■螺旋桨穿孔器襟翼（PPF）由于设计上的自由度和在不牺牲主要血管的情况下覆盖各种缺陷的能力而变得越来越受欢迎。目前用于上肢重建的PPFs的报道尚未为手部重建提供指导，具体而言。本研究旨在回顾当前的文献并评估在手部重建中使用PPFs的技术。
■根据1991年至2021年发表的文章的系统审查和荟萃分析（PRISMA）首选报告项目进行了全面的文献综述。使用适当的医学主题词(MeSH)术语查询数据库搜索的记录。报告PPF的研究仅限于英语语言，并且排除了不是针对手或手指缺陷的下肢或上肢重建。研究特点，患者人口统计学，适应症,术前检查,襟翼特性，皮瓣存活,收集并发症发生率。
■在最初的1348次引文中，71进行了全文审查。最终,包括25篇独特的引文，包括12篇回顾性评论(48%)，3项前瞻性队列研究（10%），和10个案例系列(40%)。在审查中，525例患者进行了重建，共613个螺旋桨皮瓣修复手部缺损，数字,或使用18个独特的皮瓣类型。皮瓣总生存率为97.8%。急性伤口占进行重建的72.9％。平均皮瓣覆盖率为14.7cm2。并发症发生在19.8%的病例中,5.5％和6.5％的病例发生静脉充血和部分皮瓣坏死，分别,导致皮瓣故障率为2.1%。
■PPF是手动或数字重建的可靠选择，允许外科医生在不牺牲局部脉管系统的情况下覆盖各种缺陷。尽管报告的并发症发生率接近20%，这些文章中包括的几乎所有静脉充血和部分皮瓣坏死的皮瓣均已解决，无需二次干预。保留了良好的整体皮瓣存活率。
■根据1991年至2021年发表的文章的系统审查和荟萃分析（PRISMA）首选报告项目进行了全面的文献综述。使用适当的医学主题词(MeSH)术语查询数据库搜索的记录。报告PPF的研究仅限于英语语言，并且排除了不是针对手或手指缺陷的下肢或上肢重建。研究特点，患者人口统计学，适应症,术前检查,襟翼特性，皮瓣存活,收集并发症发生率。
■在最初的1348次引文中，71进行了全文审查。最终,包括25篇独特的引文，包括12篇回顾性评论(48%)，3项前瞻性队列研究（10%），和10个案例系列(40%)。在审查中，525例患者进行了重建，共613个螺旋桨皮瓣修复手部缺损，数字,或使用18个独特的皮瓣类型。皮瓣总生存率为97.8%。急性伤口占进行重建的72.9％。平均皮瓣覆盖率为14.7cm2。并发症发生在19.8%的病例中,5.5％和6.5％的病例发生静脉充血和部分皮瓣坏死，分别,导致皮瓣故障率为2.1%。
■PPF是手动或数字重建的可靠选择，允许外科医生在不牺牲局部脉管系统的情况下覆盖各种缺陷。尽管报告的并发症发生率接近20%，这些文章中包括的几乎所有静脉充血和部分皮瓣坏死的皮瓣均已解决，无需二次干预。保留了良好的整体皮瓣存活率。
