Fasciocutaneous Propeller Flap Based on Perforating Branch of Ulnar Artery for Soft Tissue Reconstruction of the Hand and Wrist

Jang, Hyo Seok; Lee, Young Ho; Kim, Min Bom; Chung, Joo Young; Seok, Hyun Sik; Baek, Goo Hyun

doi:10.4055/cios.2018.10.1.74

Cited by 11 publications

(7 citation statements)

References 22 publications

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“…The most important flaps that can be a replacement for RAPF are certainly the ulnar artery perforator flap and retrograde posterior interosseus artery flap. Nutrition of ulnar artery perforator flap is based on distal septocutaneous perforators of ulnar artery 32 . It is suitable for covering defects on the ulnar side of the wrist and hand.…”

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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“…[7][8][9] To achieve a satisfactory reconstruction, it is essential to consider not only a functional but also an aesthetic outcome, and balancing the recipient area's result with the donor area's morbidity. [10][11][12] In this study, we propose different skin tailored pedicles and free flaps for different hand defects; for a proper understating, we divided them into two groups: small (defects that compromise one digit or part of it) and large (defects affecting the palmar or dorsal region of the hand, as well as when more than one digit is affected) reconstructions (Fig. 1).…”

Section: Discussionmentioning

confidence: 99%

Tailored Skin Flaps for Hand Reconstruction

Vizcay

Pajardi

Zanchetta

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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We conducted a retrospective study from February 2019 to December 2021, which included all patients who had undergone a skin flap to hand reconstruction from the senior author L.T. as the first surgeon. There were no exclusion criteria. Patients' medical records were reviewed and included demographics, smoking status, presence of risk factors, type of trauma, flap reconstruction, dimensions, reoperations, operative time, ischemia time, and long-term complications.

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“…In this study we assessed patients' satisfaction regarding donor site morbidity and aesthetic outcome of the flap as two separate items as shown in table (3) and we gave the patients 4 choices in the questionnaire, in contrast to Ignatiadis et al (21) and Jang et al (28) who gave their patients three choices only in the questionnaire, also they did not separate donor site from the flap itself during assessment of patients' satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Forearm, Wrist and Hand Skin Defects With Local Perforator Flaps

El-Mahy

Atiyya

Diab

et al. 2019

Ain Shams Medical Journal

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Background: During the last decades, anatomical studies on skin vascularization provided the base for the development of flaps nourished by perforating arteries and preserving major vessels. In the last years, perforator flaps have become an appealing option for coverage of a large range of defects as they allow for great freedom in design and for reconstruction of difficult wounds with minimal donor-site morbidity, but doubts regarding their reliability have overshadowed its safety in clinical practice. Aim of the Work: This prospective clinical study is conducted to assess the reliability and efficacy of local perforator flaps in coverage of hand, wrist, and forearm skin defects. Patients and methods: We conducted a prospective study involving 20 patients with hand, wrist, and forearm skin defects and were covered with local radial and ulnar arteries perforator flaps. Postoperative complications were recorded and assessment of patients' satisfaction as regards donor site morbidity and aesthetic outcome of the flap was done by a questionnaire at the outpatient clinic and the results were classified as unsatisfactory, satisfactory, good, and very good. Vancouver Scar Scale was applied as an objective tool for scar assessment postoperative. Three-month follow up was the end point of this study. Results: Radial artery perforator flaps were done in 11 cases (55 %) and ulnar artery perforator flaps in 9 cases (45%).Temporary venous congestion happened in 19 cases, distal tip necrosis in 10 cases, superficial epidermolysis in 8 cases, and arterial insufficiency in one case. Mean operative time was 63.8 min., 70.64 min. in RA perforator flaps and 55.44 min. in UA perforator flaps. Conclusion: Perforator flaps are a reliable tool for upper extremity coverage, with a low rate of failure and secondary surgery. These flaps are particularly useful for covering small and medium sized defects in the distal one third of the forearm, wrist, and hand; and they represent a reliable and effective alternative to free flaps.

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Fasciocutaneous Propeller Flap Based on Perforating Branch of Ulnar Artery for Soft Tissue Reconstruction of the Hand and Wrist

Cited by 11 publications

References 22 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

Tailored Skin Flaps for Hand Reconstruction

Reconstruction of Forearm, Wrist and Hand Skin Defects With Local Perforator Flaps

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