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The place of pedicled perforator flaps in humanitarian reconstructive surgery

      We thank Dr. Falinower and his team for making the point that pedicled perforator flaps (PPF) can be successfully used in humanitarian missions.
      • Falinower H.
      • Herlin C.
      • Hepner D.
      • Hepner Y.
      • Boissiere F.
      • Chaput B.
      Is there a place for pedicled perforator flaps in humanitarian plastic surgery?.
      We share their view that complex reconstructions can be achieved by using PPF, even in less-developed countries where health systems lack the resources or equipment to undertake specialized procedures. However, addressing this question is challenging at two levels: 1) the history of using propeller flaps and microsurgical skills in austere conditions and 2) the need of training of the clinicians in the host nation, as the presented procedures are not deprived from complications.
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      References

        • Falinower H.
        • Herlin C.
        • Hepner D.
        • Hepner Y.
        • Boissiere F.
        • Chaput B.
        Is there a place for pedicled perforator flaps in humanitarian plastic surgery?.
        J Plast Reconstr Aesthet Surg. 2020; (pii:S1748-6815(20)30063-2)
        • van Waes O.J.F.
        • Halm J.A.
        • Vermeulen J.
        • Ashford B.G.
        “The Practical Perforator Flap”: the sural artery flap for lower extremity soft tissue reconstruction in wounds of war.
        Eur J Orthop Surg Traumatol. 2013; 23: 285-289
        • Tocco-Tussardi I.
        • Presman B.
        • Cherubino M.
        • Garusi C.
        • Bassetto F.
        Microsurgery « without borders »: new limits for reconstruction of post-burn sequelae in the humanitarian setting.
        Ann Burns Fire Disasters. 2016; 29: 66-70

      Linked Article

      • Is there a place for pedicled perforator flaps in humanitarian plastic surgery?
        Journal of Plastic, Reconstructive & Aesthetic SurgeryVol. 73Issue 6
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          The use of pedicled perforator flaps (PPF) has become common in developed countries in integumentary reconstruction of the trunk and limbs. In the context of humanitarian missions, the versatility that PPF offers results in significant improvement compared to local plasties, skin grafts or classic flaps. Despite such enthusiasm, however, PPF are still very little used in reconstructive surgery in humanitarian situations. Our aim was to analyse their feasibility under such conditions.
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