Reverse Posterior Interosseous Artery Flap: A Reliable, Comfortable and Versatile Flap for Coverage of Soft Tissue Defects of Hand

2020 ◽  
Vol 16 (2) ◽  
pp. 73-79
Author(s):  
Mohammed Fahud Khurram ◽  
Sudheer Kumar Maurya ◽  
Mohd Yaseen ◽  
Madhav Chowdhry
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Posterior Interosseous Artery ◽  
Thickness Skin ◽  
Hand Defects ◽  
Interosseous Artery ◽  
Posterior Interosseous Artery Flap ◽  
Loupe Magnification ◽  
Tissue Defects ◽  
Entire Treatment

Background: Soft tissue defects of the hands require coverage with soft, pliable full-thickness skin. The posterior interosseous artery (PIA) flap fulfils all these requirements and also has significant advantages over other flaps; it is a single-stage procedure that does not sacrifice major vascular axis of the hand. However, the dissection can be challenging and requires meticulous skill. The objective of the study was to evaluate the reverse PIA flap for coverage of hand soft tissue defects in terms of its safety, reliability, comfort, function and aesthetic appearance.Methods: Over a period of 3 years, patients with soft tissue defects over the dorsum of the hand and first web space were observed. A standard PIA flap was raised using loupe magnification under general or brachial anesthesia. The size and location of the defect were noted along with the size and success of the flap.Results: Twelve patients, including nine males and three females, were taken up for this procedure. All the flaps survived completely except one with marginal necrosis not requiring a secondary procedure. All patients were quite satisfied with the procedure and went on to resume their work within a month or two.Conclusion: PIA flap is a safe, reliable option with great versatility for coverage of hand defects, especially over the dorsum. A well-planned flap surgery done under loupe magnification affords excellent results. The entire treatment also requires a shorter hospital stay and allows the patient to return to work quickly.

POSTERIOR INTEROSSEOUS ARTERY FLAP: OUR EXPERIENCE AND REVIEW OF MODIFICATIONS DONE

Hand Surgery ◽  
2014 ◽  
Vol 19 (02) ◽  
pp. 181-187 ◽  
Author(s):  
Poh Ling Fong ◽  
Winston Yoon Chong Chew
Keyword(s):  
Thumb Reconstruction ◽  
Flap Survival ◽  
Posterior Interosseous Artery ◽  
Hand Defects ◽  
Interosseous Artery ◽  
Posterior Interosseous Artery Flap

This is a report on the 14 PIA flaps done in our centre for traumatic hand defects over both volar and dorsal aspects, as well as thumb reconstruction over a six-year period from 2000 to 2007. We were able to achieve reach to the DIPJ with the use of fascia extension and better flap survival with more perforators captured in the flap.

scholarly journals Reconstructive Outcomes of Extensive Soft-Tissue Defects after Palliative Mastectomy for Advanced Breast Cancer

2021 ◽  
Vol 17 (3) ◽  
pp. 169-177
Author(s):  
Taekeun Yoon ◽  
Soo Jin Woo ◽  
Ung Sik Jin
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Soft Tissue ◽  
Life Expectancy ◽  
Split Thickness Skin Graft ◽  
Tram Flap ◽  
Soft Tissue Defects ◽  
Thickness Skin ◽  
Tissue Defects

Background: In advanced breast cancer, reconstruction can be performed depending on the patient’s situation, and can improve the subsequent treatment and quality of life. We examined the effect of reconstruction after palliative mastectomy on survival and quality of life.Methods: Between April 2010 and April 2021, 40 patients underwent reconstruction after palliative mastectomy for stage-IV breast cancer. To evaluate postoperative satisfaction, changes in the global health and quality-of-life scores after reconstruction were evaluated using questionnaires by the European Organisation for Research and Treatment of Cancer. The survival rate according to reconstructive surgery was estimated by the Kaplan-Meier survival analysis.Results: Reconstruction methods included free transverse rectus abdominis musculocutaneous (TRAM) flap (n=3), pedicled latissimus dorsi (LD) flap (n=3), pedicled TRAM flap (n=2), pedicled LD with pedicled vertical rectus abdominis musculocutaneous flap (n=1), tissue expander insertion (n=3), and split-thickness skin graft (n=28). There were no major complications or decreased life expectancy due to reconstruction. All patients healed well and started conventional chemoradiotherapy at 31.3 days postoperatively. The quality-of-life scores increased from 37 to 83 after reconstruction. There was no difference in the survival rates between those who underwent reconstruction with split-thickness skin graft and flap operation (P>0.05). The mean survival time postoperatively was 43.9 months.Conclusion: Compared to primary closure, reconstruction of extensive soft-tissue defects after palliative mastectomy did not affect life expectancy or delay postoperative chemoradiotherapy; it led to an improved quality of life. Therefore, the extensive defects expected after palliative mastectomy should not influence indications for reconstruction surgery.

scholarly journals Posterior Interosseous Artery Flap for Hand Defects

2006 ◽  
Vol 62 (1) ◽  
pp. 33-35 ◽  
Author(s):  
BB Dogra ◽  
Manmohan Singh ◽  
B Chakravarty ◽  
S Basu
Keyword(s):  
Posterior Interosseous Artery ◽  
Hand Defects ◽  
Interosseous Artery ◽  
Posterior Interosseous Artery Flap

Solving Acne Inversa (Hidradenitis Suppurativa) in Crohn Disease with Buried Chip Skin Grafts

2009 ◽  
Vol 13 (3) ◽  
pp. 164-168 ◽  
Author(s):  
Oliver Bleiziffer ◽  
Adrian Dragu ◽  
Ulrich Kneser ◽  
Raymund E. Horch
Keyword(s):  
Soft Tissue ◽  
Crohn Disease ◽  
Fistula Formation ◽  
Acne Inversa ◽  
Skin Grafts ◽  
Soft Tissue Defects ◽  
Efficient Treatment ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Tissue Defects

Background: Acne inversa is a progressive chronic inflammatory disease associated with abscess and fistula formation and subsequent scarring. In recent years, an increasing number of reports have been published about acne inversa and concomitantly occurring Crohn disease. Extensive anogenitoperineal soft tissue defects represent an enormous challenge to therapy. Common treatment strategies of reconstructive surgery such as local flaps, free flaps, or split-thickness skin grafts are frequently problematic and associated with poor outcomes. Objective: The aim of this case report is to demonstrate the clinical problem of extensive anogenitoperineal soft tissue defects and to present a surgical technique that can be successfully used in such difficult cases. Methods: In both cases, extensive excision of the affected areas was carried out down to the gluteal muscles followed by intramuscular grafting of buried skin chip grafts. Results: In both cases, the final postoperative results after numerous surgeries were very good, with complete wound closure resulting in complete recovery and social reintegration. Conclusion: The technique of buried skin chip grafting has long been ignored since split-thickness skin grafting and different techniques of flap coverage evolved, but it may constitute a highly efficient treatment strategy in challenging reconstructive situations.

scholarly journals LOCAL FLAPS AND SPLIT;

2012 ◽  
Vol 19 (05) ◽  
pp. 630-635
Author(s):  
IRFAN ISHAQ ◽  
AWAIS AHMAD ◽  
GHULAM QADIR FYYAZ
Keyword(s):  
Soft Tissue ◽  
Skin Grafting ◽  
Local Flap ◽  
Sensory Deficit ◽  
Local Flaps ◽  
Soft Tissue Defects ◽  
Flap Coverage ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Tissue Defects

Background: Two point discrimination (TPD).is the minimum distance between two stimulus points on the skin, which areperceived as distinct points, Among the two types of TPD i.e., static and dynamic, static two-point discrimination (STPD) is commonly used todetermine digital nerve integrity. Local flaps usually do well in maintaining sensibility of the covered area in terms of two point discrimination incontrast to s-plit thickness skin grafts (STSG). Objective: The objective of this study was to determine the frequency of sensory deficit in termsof TPD in STSG and local flaps for soft tissue defects of fingers after three months. Study design: It was a Quasi experimental study. Settings:Patients admitted in the indoor of Plastic surgery department, Services Hospital Lahore. Period: February 2009 to January 2010. Material andMethods: Thirty five patients underwent local flap coverage and other thirty five underwent split thickness skin grafting for soft tissue defects offingers depending upon nature of defect. Patients were followed up at 2, 4, 8 and 12 weeks. Results: The sensory deficit observed at the end of12th week post operatively was in 8.6% of the patients with local flap coverage (3 patients) and 45.7% of those with STSG (16 patients).Patients with no sensory deficit were 91.4% (32 patients) in the local flap coverage and 54.3% (19 patients) in the STSG at 12th week of followup. The relative ratio of sensory deficit in local flaps and STSG was 5 (>2). Conclusions: The results of this study show that Local flaps arebetter options in terms of TPD preservation as opposed to STSG for soft tissue defects of fingers.

scholarly journals Venous super-drained posterior interosseous artery flap for dorsal hand defects

Microsurgery ◽  
2018 ◽  
Vol 38 (8) ◽  
pp. 876-881 ◽  
Author(s):  
Erhan Sönmez ◽  
Ersin Aksam ◽  
Mustafa Durgun ◽  
Onder Karaaslan
Keyword(s):  
Posterior Interosseous Artery ◽  
Dorsal Hand ◽  
Hand Defects ◽  
Interosseous Artery ◽  
Posterior Interosseous Artery Flap
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