Ergonomics and Biogeometry of Perforator/Propeller Flaps in the Lower Limb Reconstruction

Reconstruction of lower limb defects is quite challenging in terms of scarcity of locally available flaps, poor wound healing and need for prolonged immobilization. Normally also there is decreased blood supply in the anterolateral aspect of leg and foot. Leg and foot is like a peninsula with no distal tissues available for proximal reconstruction. Also there is a paucity of loose tissue in leg and foot hence to reconstruct with a flap with least donor morbidity requires more expertise from the reconstructive surgeon. Local fasciocutaneous flaps, various muscle/ musculocutaneous flaps and free flaps were widely used. The era of perforator flaps began in 1989 describing their application and the great potential in harvesting of perforator flaps for lower limb defects.