Freestyle perforator flaps: an innovative approach to soft tissue reconstruction

Resurfacing of soft tissue defects consequent to skin cancer, melanoma, or sarcoma excisionin different anatomical districts represents a difficult challenge for the plastic surgeon. Classicreconstructive procedures are frequently charged by unsatisfactory results. The introduction of perforatorflaps in the clinical practice represented a revolution in the field of reconstructive plastic surgery.The technique further evolved with the introduction of the freestyle concept, allowing one to harvest askin flap fromany region of the body where an appropriate and detectable Doppler signal is present andto resurface soft tissue defects mobilizing the surrounding tissues, which present similar featurescompared with the recipient site in terms of color and texture, on a consistent vascular source and in atension-free manner. The authors present their personal approach to the reconstruction of soft tissuedefects after excision for a basal cell carcinoma involving the medial tibial region.