A Case Report on the Lumbar Artery Perforator Flap for Coverage of a Non-Healing Ulcer on the Back

M Lopamudra; Manabhanjan Jena

doi:10.31584/jhsmr.20251265

Authors

M Lopamudra Department of Plastic Surgery, IMS & SUM Hospital, Siksha‘O’Anusandhan, Deemed to be University, Bhubaneswar, Odisha 751030, India.
Manabhanjan Jena Consultant Cardiologist, Utkal Hospital, Bhubaneswar, Odisha 751030, India.

DOI:

https://doi.org/10.31584/jhsmr.20251265

Keywords:

Lumbar, perforator flaps

Abstract

The lumbar arteries are critical for supplying blood to the lower back and flank regions. They provide a robust vascular network that can be utilized for flap surgeries, potentially enhancing flap viability and reducing complications associated with flap loss. The vascular anatomy and skin territory supplied by a single lumbar artery are crucial for establishing a clinically reliable flap that minimizes donor site complications. To address the problem, surgery was performed on the vascular anatomy of the lumbar arteries along with the skin territory supplied by a single lumbar artery. The following case is of a 65-year-old man who presented with a non-healing ulcer in the middle of his back for 9 months. The lumbar artery perforator flap (LAP flap) procedure was performed in this study. The patient underwent tumor excision and split-thickness skin graft for a growth over his back, which was proven to be dermatofibrosarcoma protuberans by histopathology. Coverage of the defect was performed using a LAP flap in a propeller fashion. The flap surgery showed a greater rotational arc and allowed for primary closure of the donor site, addressing the limitations seen in the transverse lumbosacral flaps.

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