Journals / Düzce Tıp Fakültesi Dergisi / 2026 / Volume: 28 Issue: 1

Peroneal Artery Perforator Flap Reconstruction in an Elderly Patient with Atrial Fibrillation: A Case Report

Şükrü Kasap(MUGLA SITKI KOCMAN UNIVERSITY, FACULTY OF MEDICINE)0000-0002-7885-2655
Muhammed Said Aydin(MUGLA SITKI KOCMAN UNIVERSITY, FACULTY OF MEDICINE)0009-0001-0502-8243
Mustafa Nişancı(MUGLA SITKI KOCMAN UNIVERSITY, FACULTY OF MEDICINE)0000-0003-4377-7197
Gökay Özler(MUGLA SITKI KOCMAN UNIVERSITY, FACULTY OF MEDICINE)0009-0002-7217-3894
Onur Özvurmaz(MUGLA SITKI KOCMAN UNIVERSITY, FACULTY OF MEDICINE)0000-0002-1087-3038
Pages
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Publication Date
2026-04-25
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This case demonstrates that peroneal artery perforator flaps can be safely and effectively used in an elderly patient with atrial fibrillation, highlighting their feasibility even when preoperative Doppler signals are absent.

📌 3 Key Takeaways

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Objective & Hypothesis:Lower extremity reconstruction is challenging, especially in elderly patients with comorbidities such as atrial fibrillation.
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Key Findings & Data:Although studies have shown that both new-onset and preexisting atrial fibrillation increase the risk of free tissue transfer failure and patient mortality, to our knowledge, no previous cases have described perforator flap reconstruction in patients with atrial fibrillation.
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Conclusion & Impact:This case demonstrates that peroneal artery perforator flaps can be safely and effectively used in an elderly patient with atrial fibrillation, highlighting their feasibility even when preoperative Doppler signals are absent.
🔬Design:Case Report
📍Scope:Comprehensive Sample
⚙️Variables:Atrial fibrillation · perforator flap reconstruction · peroneal artery perforator flap

Abstract

Lower extremity reconstruction is challenging, especially in elderly patients with comorbidities such as atrial fibrillation. Pedicled perforator flaps offer a reliable alternative to free tissue transfer and musculocutaneous flaps, minimizing donor site morbidity and avoiding microsurgical techniques. We report the case of an elderly patient with new onset atrial fibrillation who underwent reconstruction of a lower extremity defect using a peroneal artery perforator flap. Despite the absence of an audible Doppler signal intraoperatively, the flap survived completely. Although studies have shown that both new-onset and preexisting atrial fibrillation increase the risk of free tissue transfer failure and patient mortality, to our knowledge, no previous cases have described perforator flap reconstruction in patients with atrial fibrillation. This case demonstrates that peroneal artery perforator flaps can be safely and effectively used in an elderly patient with atrial fibrillation, highlighting their feasibility even when preoperative Doppler signals are absent.

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Cite This Article

Kasap, Ş., Aydin, M. S., Nişancı, M., Özler, G., Özvurmaz, O. (2026). Peroneal Artery Perforator Flap Reconstruction in an Elderly Patient with Atrial Fibrillation: A Case Report. Düzce Tıp Fakültesi Dergisi, Volume: 28 Issue: 1. https://doi.org/10.18678/dtfd.1817381

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References (14)

  1. AlMugaren FM, Pak CJ, Suh HP, Hong JP. Best local flaps for lower extremity reconstruction. Plast Reconstr Surg Glob Open. 2020;8(4):e2774. doi:10.1097/GOX.0000000000002774.
  2. Uyar I, Aksam E, Yit K. Reconstruction option in complex lower extremity defects where microsurgical repair is not possible: randomized bipedicled flaps. Ulus Travma Acil Cerrahi Derg. 2023;29(8):877-82. doi:10.14744/tjtes.2023.96633.
  3. Low OW, Sebastin SJ, Cheah AEJ. A review of pedicled perforator flaps for reconstruction of the soft tissue defects of the leg and foot. Indian J Plast Surg. 2019;52(1):26-36. doi:10.1055/s-0039-1688103.
  4. Ellabban MA, Awad AI, Hallock GG. Perforator-pedicled propeller flaps for lower extremity reconstruction. Semin Plast Surg. 2020;34(3):200-6. doi:10.1055/s-0040-1715154.
  5. Brunetti B, Barone M, Tenna S, Salzillo R, Segreto F, Persichetti P. Pedicled perforator-based flaps: Risk factor analysis, outcomes evaluation and decisional algorithm based on 130 consecutive reconstructions. Microsurgery. 2020;40(5):545-52. doi:10.1002/micr.30590.
  6. Tsai CH, Chen YJ, Lin YC, Liu YC, Kao HK, Mao SH. New-onset atrial fibrillation is a red flag to microvascular free tissue transfer failure in head and neck cancer patients. J Reconstr Microsurg. 2025;41(1):37-45. doi:10.1055/a-2302-6992.
  7. Yoshimura M, Shimada T, Imura S, Shimamura K, Yamauchi S. Peroneal island flap for skin defects in the lower extremity. J Bone Joint Surg Am. 1985;67(6):935-41.
  8. Hyakusoku H, Ono S. The history of propeller flaps. Semin Plast Surg. 2020;34(3):133-8. doi:10.1055/s-0040-1715157.
  9. Taylor GI, Hallock GG. In pursuit of the “perforator” in the perforator skin flap. J Reconstr Microsurg. 2021;37(3):182-92. doi:10.1055/s-0040-1716387.
  10. Gupta S, Gupta P, Khichar P, Mohammad A, Escandón JM, Kalra S. Perforator propeller flaps for lower extremity soft-tissue defect reconstruction: Shortening the learning curve. J Clin Orthop Trauma. 2022;27:101831. doi:10.1016/j.jcot.2022.101831.
  11. Blough JT, Saint-Cyr MH. Propeller flaps in lower extremity reconstruction. Clin Plast Surg. 2021;48(2):173-81. doi:10.1016/j.cps.2021.01.002.
  12. Georgescu AV, Matei IR, Bumbasirevic M, Soucacos PN. Why, when and how propeller perforator flaps in reconstructive surgery. Injury. 2019;50(Suppl 5):S3-7. doi:10.1016/j.injury.2019.10.037.
  13. Tenekeci G, Sari A, Unal S, Demir Y, Tasdelen B. The impact of risk factors on the outcome of local perforator flaps used for lower extremity reconstruction. Turk J Plast Surg. 2024;32(2):60-7. doi:10.4103/tjps.tjps_70_23.
  14. Bekara F, Herlin C, Mojallal A, Sinna R, Ayestaray B, Letois F, et al. A systematic review and meta-analysis of perforator-pedicled propeller flaps in lower extremity defects: Identification of risk factors for complications. Plast Reconstr Surg. 2016;137(1):314-31. doi:10.1097/PRS.0000000000001891.