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Chronic Wound Reconstruction with Perforator Flap

Modern reconstruction approaches in non-healing chronic wounds.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Chronic Wound Reconstruction with Perforator Flap?

Chronic wound reconstruction is a strategic approach to soft-tissue defects that fail to heal despite long-term conservative treatment. Perforator flaps (DIEP, ALT, MSAP, SCIP) preserve the muscle and provide skin and subcutaneous tissue, minimising donor-site morbidity.

Diabetic foot ulcers, venous stasis ulcers, post-radiation wounds, pressure ulcers and chronic post-surgical wounds are typical indications. Imaging with CT angiography and detection of perforators with handheld Doppler enable preoperative planning.

Symptoms

Wound that has not healed for >6 weeks
Wound bed visibility of muscle/bone/tendon
Recurrent osteomyelitis
Inadequate vascularised tissue
Negative pressure therapy unresponsive wound
Reconstruction need at functional anatomical region

Risk Factors

Diabetes mellitus and peripheral artery disease
Smoking
Malnutrition (low albumin)
Radiation history
Steroid/immunosuppressive treatment
Obesity

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Conservative treatment unresponsive chronic wound
  • Bone/tendon exposure
  • Recurrent post-surgical wound dehiscence
  • Functional impairment at extremity (joint, tendon)
  • Non-healing wound after radiotherapy

Treatment Methods

01
Comprehensive wound assessment (vascular, neurological, infection)
02
Wound debridement and infection control
03
CT angiography (perforator mapping)
04
Doppler ultrasonography (perforator localisation)
05
DIEP flap (lower abdomen — for breast and lower extremity)
06
ALT flap (anterolateral thigh — versatile)
07
MSAP flap (medial sural artery — knee, ankle)
08
Microsurgical anastomosis (vein and artery)
09
Post-operative monitoring (flap monitoring)
10
Long-term follow-up (donor-site morbidity, flap volume)

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.