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March 1, 2026Plastic & Reconstructive Surgery1 citations

“Optimizing Perforator-Based Propeller Flap Design for Distal Leg, Ankle and Hindfoot Reconstruction: A Systematic Review and Meta-Analysis”

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SHSheng-Chi HuangYYY. Albert YehWCW.J Chen

Key Points

  • To evaluate the effectiveness and safety of perforator-based propeller flaps for reconstructing distal leg and ankle defects.
  • Systematic review of existing literature on perforator-based propeller flaps
  • Meta-analysis to quantify outcomes across different studies
  • Evaluation of flap dimensions, necrosis rates, and grafting outcomes
  • Total flap necrosis rate observed was low at 2%
  • Most partial losses managed successfully with skin grafts
  • Optimal flap dimensions maintained between 40-80 cm² and width > 4.5 cm
  • Flap-to-defect ratio less than 2.5 confirmed as crucial for positive outcomes

Abstract

PPF show a low total flap necrosis rate (2%), with most partial losses closed by skin grafting. Keeping flap dimension within 40-80 cm², width > 4.5 cm, and flap-to-defect ratio < 2.5 preserves optimal outcomes, confirming PPF as dependable single-stage alternatives to free flaps for distal lower-extremity defects.Clinical Question/Level of Evidence: Therapeutic, Level III.

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Cite This Study

Huang et al. (2026) studied this question.

synapsesocial.com/papers/69a3d873ec16d51705d2f490https://doi.org/10.1097/prs.0000000000012993
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Functional and clinical outcomes of propeller flaps in lower extremity reconstruction: A systematic review2026
  2. 2Propeller Flaps for Acute Lower Limb Reconstruction After Trauma: Evidence from a Systematic Review2025 · 5 citations
  3. 3Clinical outcomes of perforator-based propeller flaps versus free flaps in soft tissue reconstruction for lower leg and foot trauma: a retrospective single-centre comparative study2024 · 15 citations
  4. 4Perforator artery analysis and salvage procedure of propeller flaps on the reconstruciton of distal lower extremity2026
  5. 5Propeller Flap: A Feasible Flap for Distal Third of Leg Defects – Two Cases Done at the Plastic Surgery Unit of the Greater Accra Regional Hospital2024