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Generally dorsal hand defects are often closed with a flap. Dorsoradial forearm artery flap has generally been used in thumb defects; however, it can also be used in the reconstruction of dorsal hand defects thanks to its wide rotation arc and appropriate pedicle length. In this case report, we presented the outcome of a case where the dorsoradial forearm flap was applied to treat the dorsal hand defect. A 27-year-old patient was admitted to emergency room with trauma on hand. Fixation of metacarpal bone fractures was performed. The dorsoradial forearm flap was elevated and inserted in order to close an opening exposing bones and tendons in the dorsum of hand. There was no complication with flap viability in the postoperative period. Patient’s joint range of motion and vital functions were acceptable. Dorsoradial forearm flap, which is generally used in thumb reconstruction, can also be used in dorsal hand defects.

Background: Sacral pressure ulcer reconstruction is frequently applied in plastic surgery practice. Although perforator flaps are frequently used, recurrence is not uncommon in patients. For this reason, using the as little area as possible during the reconstruction is vital. Therefore, we aimed to describe a mathematically standardized bilobed perforator flap design for sacral pressure ulcer reconstruction with a certain proportion and angle relation between limbs.Methods: A total of 17 patients (5 female/12 male)were included in this report. The mean age of the patients was 50.4 years (Ranging from 32 to 79 years). The patients with grade 3-4 sacral pressure ulcers were included in the report. The patients have grade 1-2 sacral ulcers or the other areas of pressure ulcer excluded. The size of the defects ranged from 8 Â 14 cm to 5 x 16 cm. For ulcers in the sacral region, we used bilobed flaps that we mathematically standardized. The length of the first limb of the flap was planned 90 vertically oriented according to the distance between the perforator zone to the distal lateral border of the defect. The width of the first limb was kept equal to the length of the defect. The orientation of the second limb of the flap was designed 90 degrees horizontally according to the first limb. Therefore, the lengths of second limbs were calculated as half of the first limb's width, and the widths of second limbs were calculated as 3 /4 width of the first limb's width.Results: A total of 10 flaps were elevated based on superior gluteal artery perforators, and seven flaps were nourished by inferior gluteal artery perforators. The mean size of the first limb of the flaps was 14.7 Â 7.2 cm (Ranging from 8 to 20 Â 6 to 13 cm). The mean size of the second limb of the flaps was 6.7 Â 5.3 cm (Ranging from 5 to 12 Â 4 to 8 cm). The mean size of defects was 10.5 Â 7.3 cm (Ranging from 8 to 14 Â 5 to 16). The mean rotation angle was 91.7 (ranging from 90 to 100). In the early postoperative period, the hematoma was detected in three patients and evacuated in one patient, resulting in wound separation. Tip necrosis was seen in a patient that was healed by wound care. No total flap loss was encountered. No late-term recurrence was seen during the follow-up. The mean follow-up time was 13.1 months (Ranging from 4 to 24 months). Conclusion:Unilateral standardized bilobed perforator can reliably be preferred in medium to large size sacral pressure ulcer defects.