PARAUMBILICAL PERFORATOR FLAP WITHOUT DEEP INFERIOR EPIGASTRIC VESSELS

With the introduction of supramicrosurgery, paraumbilical perforator f lap without a deep inferior epigastric vessel and with very small perf orator anastomoses was used for nine patients. The abdominal defects o f two patients, the lower leg or foot defects of five patients, and th e scalp defects of two patients were repaired with an island perforato r flap. The advantages of the paraumbilical perforator flap are as fol lows: (1) there is a very short operating time for flap elevation; (2) there is no invasion or sacrifice of any rectus abdominis muscle; (3) for middle-aged, obese patients, the donor site may be the best from the cosmetic point of view; (4) many small recipient vessels to anasto mose the perforator exist throughout the body; (5) a thin skin flap wi th adequate thickness can be created easily with simultaneous removal of fatty tissue; (6) secondary defatting around the perforator can be done by minor surgery under local anesthesia; and (7) a vascularized a diposal flap with adequate thickness can be created easily. This flap seems to be indicated for female patients with defects in the abdomina l wall and the lower leg. The island flap can easily resurface abdomin al skin defects, such as intestinal fistula or radiation ulcers. The f ree flap is suitable for covering defects in the lo over leg, foot, an d scalp temporarily before administration of a tissue expander.