DOI: 10.1097/PRS.0b013e3181f61ba4

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PMID: 21124195

Issn Print: 0032-1052

Publication Date: 2010/12/01


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Pedicled Perforator Flaps: A New Principle in Reconstructive Surgery

Gerhard S. Mundinger; Mitsunaga Narushima; Isao Koshima

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Excerpt

We read the article by Dr. Lee et al. on pedicled perforator flaps in the January of 2010 issue of the Journal with great interest.1 Although we are pleased to see that pedicled perforator flaps are receiving greater attention, we feel that this article has potentially omitted any number of useful pedicled perforator flaps. For example, we described the digital artery perforator flap for fingertip reconstruction over 4 years ago, and have further expanded the utility of this flap with recently published modifications of our original technique.2,3 Digital artery perforator flaps are pedicled rotational flaps based on perforators of the radial or ulnar digital artery. They can be harvested as adiposal-only flaps or raised with full-thickness skin and subcutaneous tissue, and are useful for reconstruction of fingertip defects. A case example of this flap is presented in Figure 1. The article would have further benefited readers by including the literature search criteria used in construction of the “evolution of flap physiology and reconstruction” database described in the abstract and by a formal reporting of these search results, neither of which appears in the article. Strict reporting of search criteria and results would validate and aid in the construction of an atlas of pedicled perforator flaps which, as suggested by the authors and outlined in Table 1 of their article,1 would benefit the clinician in designing reconstructions based on local anatomy. We applaud the authors for drawing attention to pedicled perforator flaps and look forward to future articles on the topic.
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