Comments on: “Establishing a local free-style perforator best flap choice for deep sacral and ischial pressure injuries through DP+DPD mode”

It was a great pleasure to read the study by Huang et al., reporting a case series of 23 perforator flaps to reconstruct 14 sacral and 8 ischial defects in 22 patients over a period of 5 years. They establish a reconstruction algorithm to guide the selection of an ideal free-style perforator flap that can be tailored in each wound. According to the authors, the use of free-style perforator propeller flaps enables the transference of healthy tissue into the wound, moves the suture line away from the bony prominence and maintains more probability for future donor sites. In their conclusion, Huang et al. pinpoint that the surgical algorithm proposed by them provides versatility and reliability, reaches natural esthetic outcome and reduces donor site injuries. 1 Huang H.H. Wu Z.Y. Chen X.F. et al. Establishing a local free-style perforator best flap choice for deep sacral and ischial pressure injuries through DP+DPD mode. J Plast Reconstr Aesthet Surg. 2022; Google Scholar