Cutaneous Perforators and Their Clinical Implications on Intrinsic Hand Flaps: A Systematic Review

Prasetyono, Theddeus O.H.; Menna, Clara

doi:10.1097/gox.0000000000004154

Cited by 3 publications

(2 citation statements)

References 70 publications

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“…In our series, RAPF was used for small and moderate sized defects. For the minor defects on the specific localisation of the hand, suitable alternative perforator flaps may be used such as the reverse thenar perforator flap, the ulnar palmar perforator flap, and the dorsal metacarpal artery perforator flap 34,35 . For each of them, proper indication can be found in hand surgery.…”

Section: Discussionmentioning

confidence: 99%

Versatile clinical application of radial artery perforator flap for hand and wrist reconstruction

et al. 2023

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Background/Aim. Radial artery perforator flap (RAPF) as a type of fasciocutaneous or adipofascial reverse pedicle flap, proved to be a versatile flap for reconstruction of small and moderate size soft tissue defects of the forearm, wrist, and hand. It provides suitable skin coverage with elastic subcutaneous tissue to protect exposed or damaged functional structures. The aim of this study is to summarize and analyse the results of the treatment of our patients with upper extremity soft tissue defects caused by trauma, infection, burn or tumour removal which were reconstructed with RAPF. Methods. This retrospective study includes 20 consecutive patients with skin and soft tissue defects of the hand and wrist, treated in the University Clinical Centre of Vojvodina from 2012 to 2022. Design of the flaps and length of the pedicles were determined by the recipient site. Tourniquet induced exsanguination was used during surgery for better visualization. The flaps were elevated and placed at the site of the defect. Patient and flaps? data were summarized upon their collection. Results. Distally based radial artery fasciocutaneous perforator flaps were used in all of the cases. The average age of the patients was 48 years, mostly males (64%). Defects were most often localized on the dorsal part of the hand (60%) and wrist (20%). The most common indications for surgery were trauma (45%) and tumour resection (25%). A satisfactory coverage of the defect was achieved in all 20 patients with no flap loss. Venous congestion was noted in 4 patients (20%) which resulted in partial necrosis of the flap in 3 patients (15%). Wound healing was achieved upon conservative treatment by secondary intention in two patients and with secondary suture in the last one. A surgical site infection occurred in 2 patients (10%) which withdrew after proper local and systemic therapy. Conclusion. Radial artery perforator flap proved to be a workhorse flap for soft tissue reconstruction of the upper limb. This surgical solution led to an excellent functional and aesthetic outcome in the majority of patients. Complex surgical procedures could be done simultaneously, together with reconstruction of tendons, joints, or fracture stabilisation. The reliability and safety of this flaps is confirmed through our clinical data.

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Section: Discussionmentioning

confidence: 99%

Versatile clinical application of radial artery perforator flap for hand and wrist reconstruction

et al. 2023

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“…There have been reports of a variety of techniques for preventing venous congestion, as covering the vascular pedicle with intermuscular septa and muscle fascia or surgically connecting subcutaneous veins to veins at the recipient site. By incorporating them into the flap pedicle, protection of the flap is obtained [20].…”

Section: Case Presentationmentioning

confidence: 99%

Reliability and Versatility of Posterior Interosseous Artery Flap in Reconstructing Hand Soft Tissue Defects

Elsayed,

Hassanym,

Abdel Megeed

et al. 2023

The Egyptian Journal of Plastic and Reconstructive Surgery

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Background: The posterior interosseous artery flap (PIAF) is indicated in the reconstruction of soft tissue defects on the 1 st webspace, dorsal & volar aspect of the hand and wrist. The PIAF is a long-lasting and aesthetically pleasing solution for covering deficiencies in soft tissue when bone and/or tendons are exposed on the dorsal & palmer sides of the thumb, hand & wrist.Objective: This research aimed to assess the PIA fasciocutaneous flap in reconstruction of hand defects in terms of aesthetic appearance, hand function & morbidity at the donor site.Methods: This case series research was carried out on 15 cases with soft tissue hand defects. All cases underwent full history taking, clinical evaluation, laboratory investigations and radiological evaluation with plain X-rays.Results: Regarding the scar assessment, it was good in 12 (80%) cases and fair in 3 (20%). DASH score ranged from 30-60 with a mean of 38.7±11.25. Regarding donation site problems, only 2 (13%) cases had cold intolerance and numbness. Regarding the incidence of complications, there were 1 (7%) patient had distal flap necrosis and 1 (7%) had venous congestion. The hospital stay of the studied cases ranged from 4-10 days with a mean of 6.9±1.83 day. The follow-up of the studied cases ranged from 3-6 months with a mean of 4.3±1.11 months. Conclusions:The reverse-flow posterior interosseous artery flap (PIAF) is a reliable and versatile flap for defects resurfacing of mild to moderate size on the dorsal & palmar aspect of the hand up to the MPJ, thumb up to the IP joint & 1 st web space.

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Evaluation of the cutaneous blood supply and vascular territories of the wrist

Alder,

Meaike,

Kattil

et al. 2024

Orthoplastic Surgery

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Cutaneous Perforators and Their Clinical Implications on Intrinsic Hand Flaps: A Systematic Review

Cited by 3 publications

References 70 publications

Versatile clinical application of radial artery perforator flap for hand and wrist reconstruction

Versatile clinical application of radial artery perforator flap for hand and wrist reconstruction

Reliability and Versatility of Posterior Interosseous Artery Flap in Reconstructing Hand Soft Tissue Defects

Evaluation of the cutaneous blood supply and vascular territories of the wrist

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