Perforator based flaps in burn reconstruction: A 2 years experience

Hastika Saraswati 1, Beta Subakti N 2

1 Department of Plastic Reconstructive and Aesthetic Surgery, Airlangga University/ Dr.Soetomo General Hospital Surabaya, Surabaya, East Java, 60285,
2 Department of Plastic Reconstructive and Aesthetic Surgery, Airlangga University/ Dr.Soetomo General Hospital Surabaya, Surabaya, East Java, 60285,

Background: Burn wounds manifests in wide array of problems, from full-thickness burn in early phase and contracture in late phase. Reconstruction will excel in function and cosmetic mostly with flap coverage, but local flap seldom fulfil this task. Alternative options are free tissue transfer, pedicle or perforator based flap. Since its introduction by Koshima in 1989, perforator flap has been developed in its many aspect. It has advantages in utilizing adjacent tissue with its similar character to recipient, and also able to cover relatively larger defect. Perforator based flap doesn’t need specialized instrument and can be learned through a simpler learning curved. In this article we like to report our 2 years experience in utilizing perforator based flap for burn reconstruction.

Patient and method: Data were collected from medical records in period from 1 January 2014 to 15 March 2016. Perforators mapped using handheld Doppler pre-operatively

Result: We performed 21 operations. Flaps are anterolateral thigh perforator flap, reversed anterolateral thigh perforator flap, lateral arm flap, reversed radial artery perforator flap, ulnar artery perforator flap, and medial thigh perforator flap, supraclavicular artery perforator flap, thoracodorsalis artery perforator flap, radial artery peforator flap and lateral genu perforator flap, and dorsal metacarpal artery perforator flap. Operations were performed by single operator. There were 4 cases with partial necrosis.

Conclusion: Perforator based flaps are considered to be an appealing option for burn reconstruction due to its benefits compared to other available modalities.

Key Words

burn reconstruction, perforator flap, microsurgery, burn contracture, dorsal metacarpal, ulnar artery, radial artery, posterior interosseus, thoracodorsal, medial thigh perforator, lateral genu perforator, anterolateral thigh.


Beta Subakti N, MD
I am an assistant professor at Airlangga University Medical School / Dr. Sutomo General Hospital since 2012 after finished my training at plastic surgery in the same hospital. I have performed one year international fellowship at Seoul National University Bundang Hospital in 2013. Our hospital is a referral burn center in east part of Indonesia, especially java island. I have performed reconstructions in burn related morbidities, in acute and late phase.


ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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