Application and innovation of functional perforator flaps in reconstruction of tissue defects_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 WANG Xin ^1,2 , PAN Jiadong ^1,2

1. Department of Hand Microsurgery and Plastic Reconstructive Surgery, Ningbo No.6 Hospital, Ningbo Zhejiang, 315043, P. R. China;
2. Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo Zhejiang, 315043, P. R. China;

Corresponding?author：

WANG Xin, Email: dr.wangxin@qq.com

Keywords：

Functional perforator flap; chimeric flap; composite tissue defect

DOI：

10.7507/1002-1892.202508001

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review the nomenclature, functional unit construction, technical essentials, and prevention and treatment of complications of functional perforator flaps, so as to provide references for the structural and functional reconstruction of composite tissue defects. Methods By retrieving and analyzing domestic and foreign literature on anatomical research, technical innovation and clinical application of functional design and application of perforator flaps, combined with the clinical practice of our team, the methods for harvesting and integrating functional units of perforator flaps were summarized. Results Functional perforator flap refers to a perforator flap that, on the basis of perforator blood supply, carries one or more tissue functional units (such as muscles, nerves, lymphatic vessels, lymph nodes, bones, mucous membranes, joints or articular cartilages, etc.) with sufficient blood supply located in the supra-fascia and/or sub-fascia, and is used to reconstruct one or more functions of the recipient site. The design and transfer of functional perforator flaps should not only meet the needs of precise coverage of the wound, but also reconstruct the functions of the recipient site such as muscle contraction, flap sensation, lymphatic drainage, blood flow bridging, bone growth, glandular secretion or joint movement, while avoiding iatrogenic dysfunction in the donor site. Conclusion Functional perforator flaps have broken through the limitation of “wound coverage” and realize the integrated reconstruction of “structure-function-aesthetics”.

Citation： WANG Xin, PAN Jiadong. Application and innovation of functional perforator flaps in reconstruction of tissue defects. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(9): 1071-1075. doi: 10.7507/1002-1892.202508001 Copy

1.	王欣, 潘佳棟, 陳宏. 穿支皮瓣技術在四肢組織缺損重建中的臨床應用. 中華創傷雜志, 2017, 33(2): 107-110.
2.	李苗鐘, 潘佳棟, 王欣, 等. 特殊形式穿支皮瓣在四肢嚴重創傷修復中的應用進展. 中華創傷雜志, 2017, 33(2): 137-140.
3.	李倩, 肖海濤, 岑瑛. 選擇性修薄股前外側皮瓣修復足跟及足跟后區缺損. 中國修復重建外科雜志, 2018, 32(3): 350-353.
4.	王新宏, 李海軍, 王保山, 等. 股外側肌淺區嵌合移植急診一期修復前臂嚴重擠壓傷的臨床效果. 中華損傷與修復雜志 (電子版), 2024, 19(1): 41-45.
5.	潘佳棟, 王欣, 尹善青, 等. 功能性胸背動脈穿支皮瓣嵌合背闊肌游離移植重建前臂復合組織缺損13例. 中華顯微外科雜志, 2024, 47(3): 241-247.
6.	曹廣超, 鄭大偉, 孫峰, 等. 預構感覺皮瓣修復足跟軟組織撕脫傷. 中國修復重建外科雜志, 2015, 29(2): 198-201.
7.	潘文杰, 鄧呈亮. 鎖骨上血管化淋巴結移植治療淋巴水腫的研究進展. 中國修復重建外科雜志, 2023, 37(6): 736-741.
8.	王欣, 潘佳棟. 功能性穿支皮(組織)瓣的概念與應用. 中華顯微外科雜志, 2024, 47(6): 611-613.
9.	Pan JD, Wang X. Full hand reconstruction of degloving injury at the cost of minimal destruction in the donor feet Z. 9th congress of world society for reconstructive microsurgery, Best innovative case, 2017, Seoul, Korea.
10.	Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg, 1987, 40(2): 113-141.
11.	張長青. 敢為人先, 久久為功. 中華顯微外科雜志, 2023, 46(4): 361-367.
12.	Slezak S, McGibbon B, Dellon AL. The sensational transverse rectus abdominis musculocutaneous (TRAM) flap: return of sensibility after TRAM breast reconstruction. Ann Plast Surg, 1992, 28(3): 210-217.
13.	Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg, 1994, 32(1): 32-38.
14.	Tajziehchi P, Dayaratna N, Holten BE, et al. Flap neurotisation improves sensation outcomes in abdominally based autologous breast reconstruction: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg, 2024, 90: 280-291.
15.	Ma H, Van Dessel J, Shujaat S, et al. Long-term functional outcomes of vascularized fibular and iliac flap for mandibular reconstruction: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg, 2021, 74(2): 247-258.
16.	王欣, 潘佳棟, 陳宏, 等. 吻合血管蒂的踇甲皮瓣包繞第二趾復合組織游離移植再造拇指. 中華移植雜志 (電子版), 2010, 4(2): 119-123.
17.	Clodius L, Smith PJ, Bruna J, et al. The lymphatics of the groin flap. Ann Plast Surg, 1982, 9(6): 447-458.
18.	Almadani H, Lu J, Bokhari S, et al. Simultaneous vascularized lymph node transfer and breast reconstruction: A systematic review. J Clin Med, 2025, 14(5): 1694. doi: 10.3390/jcm14051694.
19.	Amendola F, Spadoni D, Velazquez-Mujica J, et al. The triple conjoined scapular-latissimus dorsi-groin flap for reconstruction of long lower extremity degloving injury: A case report. Microsurgery, 2022, 42(3): 277-281.
20.	Dong K, Zhou Y, Xu YQ, et al. Anterolateral thigh flow-through flap: A versatile method for reconstruction of complex extremity defects. Microsurgery, 2023, 43(7): 685-693.

1. 王欣, 潘佳棟, 陳宏. 穿支皮瓣技術在四肢組織缺損重建中的臨床應用. 中華創傷雜志, 2017, 33(2): 107-110.
2. 李苗鐘, 潘佳棟, 王欣, 等. 特殊形式穿支皮瓣在四肢嚴重創傷修復中的應用進展. 中華創傷雜志, 2017, 33(2): 137-140.
3. 李倩, 肖海濤, 岑瑛. 選擇性修薄股前外側皮瓣修復足跟及足跟后區缺損. 中國修復重建外科雜志, 2018, 32(3): 350-353.
4. 王新宏, 李海軍, 王保山, 等. 股外側肌淺區嵌合移植急診一期修復前臂嚴重擠壓傷的臨床效果. 中華損傷與修復雜志 (電子版), 2024, 19(1): 41-45.
5. 潘佳棟, 王欣, 尹善青, 等. 功能性胸背動脈穿支皮瓣嵌合背闊肌游離移植重建前臂復合組織缺損13例. 中華顯微外科雜志, 2024, 47(3): 241-247.
6. 曹廣超, 鄭大偉, 孫峰, 等. 預構感覺皮瓣修復足跟軟組織撕脫傷. 中國修復重建外科雜志, 2015, 29(2): 198-201.
7. 潘文杰, 鄧呈亮. 鎖骨上血管化淋巴結移植治療淋巴水腫的研究進展. 中國修復重建外科雜志, 2023, 37(6): 736-741.
8. 王欣, 潘佳棟. 功能性穿支皮(組織)瓣的概念與應用. 中華顯微外科雜志, 2024, 47(6): 611-613.
9. Pan JD, Wang X. Full hand reconstruction of degloving injury at the cost of minimal destruction in the donor feet Z. 9th congress of world society for reconstructive microsurgery, Best innovative case, 2017, Seoul, Korea.
10. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg, 1987, 40(2): 113-141.
11. 張長青. 敢為人先, 久久為功. 中華顯微外科雜志, 2023, 46(4): 361-367.
12. Slezak S, McGibbon B, Dellon AL. The sensational transverse rectus abdominis musculocutaneous (TRAM) flap: return of sensibility after TRAM breast reconstruction. Ann Plast Surg, 1992, 28(3): 210-217.
13. Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg, 1994, 32(1): 32-38.
14. Tajziehchi P, Dayaratna N, Holten BE, et al. Flap neurotisation improves sensation outcomes in abdominally based autologous breast reconstruction: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg, 2024, 90: 280-291.
15. Ma H, Van Dessel J, Shujaat S, et al. Long-term functional outcomes of vascularized fibular and iliac flap for mandibular reconstruction: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg, 2021, 74(2): 247-258.
16. 王欣, 潘佳棟, 陳宏, 等. 吻合血管蒂的踇甲皮瓣包繞第二趾復合組織游離移植再造拇指. 中華移植雜志 (電子版), 2010, 4(2): 119-123.
17. Clodius L, Smith PJ, Bruna J, et al. The lymphatics of the groin flap. Ann Plast Surg, 1982, 9(6): 447-458.
18. Almadani H, Lu J, Bokhari S, et al. Simultaneous vascularized lymph node transfer and breast reconstruction: A systematic review. J Clin Med, 2025, 14(5): 1694. doi: 10.3390/jcm14051694.
19. Amendola F, Spadoni D, Velazquez-Mujica J, et al. The triple conjoined scapular-latissimus dorsi-groin flap for reconstruction of long lower extremity degloving injury: A case report. Microsurgery, 2022, 42(3): 277-281.
20. Dong K, Zhou Y, Xu YQ, et al. Anterolateral thigh flow-through flap: A versatile method for reconstruction of complex extremity defects. Microsurgery, 2023, 43(7): 685-693.

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