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.
