scholarly journals Versatility of Free Cutaneous Flaps for Upper Extremity Soft Tissue Reconstruction

2017 ◽  
Vol 09 (02) ◽  
pp. 058-066 ◽  
Author(s):  
Howard Wang ◽  
Jose Alonso-Escalante ◽  
Brian Cho ◽  
Ramon DeJesus
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Team Approach ◽  
Soft Tissue Reconstruction ◽  
Epigastric Artery ◽  
Reconstructive Microsurgery ◽  
Flap Design ◽  
Tissue Reconstruction

AbstractThe goals of upper extremity soft tissue reconstruction should go well beyond providing coverage and restoring function. As the field of reconstructive microsurgery has evolved, free cutaneous flaps (FCFs) are gaining wider application. The advantages of FCF include minimizing donor-site morbidity by preserving the muscle and fascia, improving versatility of flap design, and superior aesthetic results. This review highlights the application of anterolateral thigh, superficial circumflex iliac artery, deep inferior epigastric perforator, superficial inferior epigastric artery, and flow-through flaps for reconstruction of upper extremity defects. These flaps share several qualities in common: well-concealed donor sites, preservation of major arteries responsible of providing inflow to distal extremity, and potential for a two-team approach (donor and recipient sites). While the choice of flaps should be decided based on individual patient and defect characteristics, FCF should be considered as excellent options to achieve the goals of upper extremity reconstruction.

scholarly journals Retrospective analysis of free temporoparietal fascial flap for defect reconstruction of the hand and the distal upper extremity

2020 ◽  
Author(s):  
Wibke Müller-Seubert ◽  
Raymund E. Horch ◽  
Vanessa Franziska Schmidt ◽  
Ingo Ludolph ◽  
Marweh Schmitz ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Soft Tissue ◽  
Upper Extremity ◽  
Reconstructive Surgery ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Soft Tissue Reconstruction ◽  
Flap Necrosis ◽  
Fascial Flap ◽  
Tissue Reconstruction

Abstract Introduction Soft tissue reconstruction of the hand and distal upper extremity is challenging to preserve the function of the hand as good as possible. Therefore, a thin flap has been shown to be useful. In this retrospective study, we aimed to show the use of the free temporoparietal fascial flap in soft tissue reconstruction of the hand and distal upper extremity. Methods We analysed the outcome of free temporoparietal fascial flaps that were used between the years 2007and 2016 at our institution. Major and minor complications, defect location and donor site morbidity were the main fields of interest. Results 14 patients received a free temporoparietal fascial flap for soft tissue reconstruction of the distal upper extremity. Minor complications were noted in three patients and major complications in two patients. Total flap necrosis occurred in one patient. Conclusion The free temporoparietal fascial flap is a useful tool in reconstructive surgery of the hand and the distal upper extremity with a low donor site morbidity and moderate rates of major and minor complications.

A Homodigital Reverse Pedicle Island Flap in Soft Tissue Reconstruction of the Finger and the Thumb

1994 ◽  
Vol 19 (2) ◽  
pp. 135-141 ◽  
Author(s):  
N. S. NIRANJAN ◽  
J. R. ARMSTRONG
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Single Stage ◽  
Island Flap ◽  
Tissue Loss ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

A single stage homodigital reverse pedicle island flap is described for the repair of volar or dorsal tissue loss on the finger or thumb. Donor site morbidity is minimal, and the length of the digit is preserved. Satisfactory function results in 25 patients are presented.

Soft Tissue Reconstruction

2020 ◽  
pp. 63-74
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Open Fractures ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction ◽  
Wound Excision

Soft tissue coverage of open fractures with well-vascularised tissues should be performed within 72 hours of injury or at the same time as internal fixation. It may be in the form of local or free flaps, and may comprise muscle, fasciocutaneous tissues, or both. Flap selection depends on multiple factors, including the size and location of the defect following wound excision, availability of flaps, and donor site morbidity. Local flaps are usually used to cover defects with a limited zone of injury. Anastomoses for free flaps should be performed outside the zone of injury. Experimental data suggest that coverage with muscle leads to improved healing of fractures. However, there is currently little clinical evidence to support the use of one form of soft tissue cover over another for open fractures of the lower limb. The plastic surgeon must always consider the donor site morbidity of the flap(s) chosen.

scholarly journals Awkward defects around the elbow: The radial recurrent artery flap revisited

2016 ◽  
Vol 49 (03) ◽  
pp. 357-361
Author(s):  
Maksud M. Devale ◽  
Rohit P. Munot ◽  
Chirag A. Bhansali ◽  
Neeraj D. Bhaban
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Elbow Joint ◽  
Donor Site ◽  
Distal Humerus ◽  
Donor Site Morbidity ◽  
Soft Tissue Reconstruction ◽  
Posterior Aspect ◽  
Tissue Reconstruction ◽  
Radial Recurrent Artery

ABSTRACT Background: Soft tissue defects on the posterior aspect of the elbow are commonly seen in patients treated with internal fixation for fractures around the elbow joint. An axial flap based on the radial recurrent artery (RRA) is very useful for such defects, especially if a posterior midline arm incision has been taken for skeletal fixation. The aim of this study is to describe the usefulness of RRA flap (based on the RRA) in the management of such defects. Materials and Methods: We present a retrospective analysis of 4 cases managed with the RRA flap for soft tissue reconstruction of defects around the elbow joint at our institute from January 2015 to August 2016. All the patients were males with a history of exposed implant following internal fixation of olecranon/distal humerus fracture. The size of defects ranged from 4 cm × 4 cm to 7 cm × 5 cm. Results of the analysis are presented here. Results: All flaps survived completely. There was no infection, hematoma or distal neurovascular deficit. There was minimal donor site morbidity. Conclusion: The RRA flap is a useful, simple flap for defects around the elbow joint in select patients providing one stage, reliable, cosmetically acceptable coverage.

scholarly journals Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverage

2017 ◽  
Vol 50 (02) ◽  
pp. 201-206
Author(s):  
Akram Hussain Bijli ◽  
Sheikh Adil Bashir ◽  
Altaf Rasool ◽  
Mir Yasir ◽  
Adil Hafeez Wani ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Patient Comfort ◽  
Soft Tissue Reconstruction ◽  
Recipient Site ◽  
Epigastric Artery ◽  
Volar Aspect ◽  
Deep Inferior Epigastric Artery ◽  
Tissue Reconstruction ◽  
Versatile Technique

ABSTRACT Background: While contemplating any difficult soft tissue reconstruction, patient comfort and compliance is of paramount importance. Reconstruction of the volar aspect of fingers and hand by the ipsilateral pedicled flaps (groin flap, abdominal flaps) is demanding as the flap inset is difficult for the surgeon and very uncomfortable for the patient. This often leads to flap complications. For the comfort of the patient, better compliance and ease of complete inset, we planned to manage soft tissue defects of the volar aspect of fingers and hand by a new contralateral pedicled lumbo-umbilical flap. This flap is based on the paraumbilical perforators of deep inferior epigastric artery. Materials and Methods: The contralateral pedicled lumbo-umbilical flap was used in eight patients with high-tension electrical burn injuries involving the volar aspect of fingers and hand. The patients were closely observed for first 6 weeks for any flap or donor site complications and then followed monthly to assess donor and recipient site characteristics for 6 months to 2 years. Results and Conclusion: Large flaps up to 8 cm × 16 cm were raised. All but one flaps survived completely. All patients were mobilised within 48 h and five were discharged in less than a week after initial inset. The flap is reliable, easy to harvest and easy to inset on the volar aspect of fingers. The arm is positioned in a very comfortable position. The main disadvantage, however, is a conspicuous abdominal scar.

“Spare Part” Forearm Free Flaps Harvested from the Amputated Limb for Coverage of Amputation Stumps

1997 ◽  
Vol 22 (5) ◽  
pp. 615-619 ◽  
Author(s):  
M. J. WEINBERG ◽  
M. M. AL-QATTAN ◽  
J. MAHONEY
Keyword(s):  
Soft Tissue ◽  
Radial Artery ◽  
Donor Site ◽  
Free Flaps ◽  
Spare Part ◽  
Donor Site Morbidity ◽  
Soft Tissue Reconstruction ◽  
Amputation Stumps ◽  
Tissue Reconstruction ◽  
Different Tissues

The use of “spare part” flaps from a non-replantable limb to cover amputation stumps in the upper extremity preserves limb length, provides durable coverage and sensation and will avoid additional donor site morbidity. We have studied the blood supply of the forearm based on the radial artery. The potential for harvesting different tissues is confirmed. In five clinical cases reliable primary soft tissue reconstruction was achieved, even in the presence of trauma.

scholarly journals Comparison of Fasciocutaneous and Muscle-based Free Flaps for Soft Tissue Reconstruction of the Upper Extremity

2019 ◽  
Vol 7 (12) ◽  
pp. e2543
Author(s):  
Christoph Koepple ◽  
Ann-Katrin Kallenberger ◽  
Lukas Pollmann ◽  
Gabriel Hundeshagen ◽  
Volker J. Schmidt ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Free Flaps ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction
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