A Propeller Flap for Single-Stage Nose Reconstruction in Selected Patients: Supratrochlear Artery Axial Propeller Flap

 

 Buy Article Permissions and Reprints

Abstract

The paramedian forehead flap is the gold standard technique for nose reconstruction. It requires two different surgical operations which prolonged the postoperative dressing and care. We present our 5-year experience with a propeller flap based on the supratrochlear artery, which allows one-stage transfer of the forehead skin to the nose without the need for pedicle division. This technique is indicated in a selected group of patients who are not suitable for multiple-stage reconstructions because they have concurrent medical conditions, reduced mobility, or live far away from specialized medical centers. We have renamed this procedure as supratrochlear artery axial propeller flap, from the acronym STAAP flap, to stress the axial, well known and constant, vascularization of the flap. In the past 5 years, we have been performing 25 STAAP flaps; full-thickness nasal reconstruction was performed in 11 cases. The patients were 16 males and 9 females, with a mean age of 79.5 years. All patients had multiple comorbidities. Complete flap survival was observed in 23 cases and healing was complete in 7 days. In two cases, there was a partial distal necrosis of the flap treated conservatively. Cosmetic results were good and the patient's satisfaction was significant. These results indicate that the STAAP flap is a reliable and useful technique in selected cases, as old or noncompliant patients who benefit from a one-stage technique of nose reconstruction.

• References

• 1 Menick FJ. A 10-year experience in nasal reconstruction with the three-stage forehead flap. Plast Reconstr Surg 2002; 109 (6) 1839-1855 , discussion 1856–1861
  CrossrefPubMedGoogle Scholar
• 2 Menick FJ. Nasal reconstruction. Plast Reconstr Surg 2010; 125 (4) 138e-150e
  CrossrefPubMedGoogle Scholar
• 3 Geddes CR, Morris SF, Neligan PC. Perforator flaps: evolution, classification, and applications. Ann Plast Surg 2003; 50 (1) 90-99
  CrossrefPubMedGoogle Scholar
• 4 Yang D, Tang M, Geddes CR, Morris SF. Vascular anatomy of the integument of the head and Neck. In: Blondeel PN, Morris SF, Hallock GG, Neligan PC, , eds. Perforator Flaps Anatomy, Tecknique and Clinical Applications. St. Louis, MO: QMP; 2006: 134-160
  Google Scholar
• 5 Hyakusoku H, Yamamoto T, Fumiiri M. The propeller flap method. Br J Plast Surg 1991; 44: 53-54
  CrossrefPubMedGoogle Scholar
• 6 Pignatti M, Pasqualini M, Governa M, Bruti M, Rigotti G. Propeller flaps for leg reconstruction. J Plast Reconstr Aesthet Surg 2008; 61 (7) 777-783
  CrossrefPubMedGoogle Scholar
• 7 D'Arpa S, Cordova A, Pirrello R, Moschella F. Free style facial artery perforator flap for one stage reconstruction of the nasal ala. J Plast Reconstr Aesthet Surg 2009; 62 (1) 36-42
  CrossrefPubMedGoogle Scholar
• 8 D'Arpa S, Cordova A, Pirrello R, Moschella F. One-stage reconstruction of the nasal ala: the free-style nasolabial perforator flap. Plast Reconstr Surg 2009; 123 (2) 65e-66e
  CrossrefPubMedGoogle Scholar
• 9 Cordova A, Di Lorenzo S, Moschella F. “Composite graft”: a simple option for nasal lining. Int J Dermatol 2007; 46 (4) 417-421
  CrossrefPubMedGoogle Scholar
• 10 Converse JM, Wood-Smith D. Experiences with the forehead island flap with a subcutaneous pedicle. Plast Reconstr Surg 1963; 31: 521-527
  CrossrefPubMedGoogle Scholar
• 11 Park SS. The single-stage forehead flap in nasal reconstruction: an alternative with advantages. Arch Facial Plast Surg 2002; 4 (1) 32-36
  CrossrefPubMedGoogle Scholar
• 12 Mombaerts I, Gillis A. The tunneled forehead flap in medial canthal and eyelid reconstruction. Dermatol Surg 2010; 36 (7) 1118-1125
  CrossrefPubMedGoogle Scholar
• 13 Cordova A, D'Arpa S, Moschella F. A new one-stage method for nose reconstruction: the supratrochlear artery perforator propeller flap. Plast Reconstr Surg 2012; 129 (3) 571e-573e
  CrossrefPubMedGoogle Scholar
• 14 Pignatti M, Ogawa R, Hallock GG , et al. The “Tokyo” consensus on propeller flaps. Plast Reconstr Surg 2011; 127 (2) 716-722
  CrossrefPubMedGoogle Scholar
• 15 Rohrich RJ, Griffin JR, Ansari M, Beran SJ, Potter JK. Nasal reconstruction—beyond aesthetic subunits: a 15-year review of 1334 cases. Plast Reconstr Surg 2004; 114 (6) 1405-1416 , discussion 1417–1419
  PubMedGoogle Scholar