Bibliographic record
Abstract
BACKGROUND: Conventional fasciocutaneous flaps in reconstructive surgery, especially in the lower extremities, have limited utility. Traditional flaps are essentially random pattern, often require delays, and are limited in mobility and reach. Islanded fasciocutaneous flaps pedicled on perforators can be raised anywhere on the body and have a reliable blood supply and greater freedom of movement. However, venous compromise is a common problem. METHODS: A new approach to raising conventional fasciocutaneous flaps while including and retaining perforators in their substance was used to offset these disadvantages. This concept offers a dual blood supply to the flap from the dissected perforator plus the flap base. The approach was attempted in 12 cases and used successfully in 10. In two cases, the flaps were converted to pure islanded perforator flaps because of limited movement. Fasciocutaneous perforator-plus flaps were used in six patients with lower limb trauma and one patient with postburn elbow contracture. Peninsular flaps were planned to include known or identified perforators, which were dissected to allow mobility. RESULTS: All flaps survived completely and none exhibited venous compromise. In three patients, perforator-plus flaps were used to the medial hemisoleus muscle while providing coverage to exposed tibial fractures. The muscle flap was based either proximally or distally, and a segmental perforator was dissected and retained. There were no complications relating to flap congestion or necrosis except wound infection in two patients, one each in the fasciocutaneous and muscle flap groups. Both responded to conservative treatment. No case required reoperation. CONCLUSION: The perforator-plus flap appears to be a versatile and reliable option in lower limb injuries and other diverse indications, in both the emergency and the elective settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".