Our Experience with the Use of the Dorsal Ulnar Artery Flap in Hand and Wrist Tissue Cover

Antonopoulos, D; Kang, Norbert; DeBono, Raymond

doi:10.1016/s0266-7681(97)80437-8

Cited by 14 publications

(11 citation statements)

References 3 publications

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“…These ideas are good in theory, but the flap donor sites are far from the hand. There are possible reconstructive options that could be undertaken in the upper limb, including the posterior interosseous forearm flap, 8 the dorsal ulnar artery flap, 9 the radial artery pedicle perforator flap, 3 the ulnar artery perforator flap, 10 and the neurocutaneous flap in upper extremities. 11 The advantages of using upper limb flaps include superior color and thickness match and the possibility of using a local pedicled perforator flap rather than a free microvascular transfer.…”

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confidence: 99%

Vascular Anatomy and Clinical Application of the Free Proximal Ulnar Artery Perforator Flaps

Wei¹,

Shi

et al. 2014

Plastic and Reconstructive Surgery Global Open

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Background:There is a dearth of detailed published work on the anatomy of ulnar artery perforators. The objective of this study was to fully document the vascular basis of the free proximal ulnar artery perforator flap and report its use in reconstruction of the hand.Methods:(1) The ulnar artery perforators were studied in 25 fresh cadavers and 10 cast preparations. Cadavers were injected with lead oxide for 3-dimensional reconstruction. The origin, course, and distribution of the ulnar artery perforators were comprehensively documented. (2) Between August 2011 and January 2013, 29 free proximal ulnar artery perforator flaps were utilized for reconstruction of soft-tissue defects of the hand in 25 patients. Flap size varied from 3.5 × 2.0 cm to 24.0 × 4.0 cm, with a consistent thickness of approximately 3 mm.Results:(1) There were 7 ± 2.0 ulnar artery perforators. The average external diameter was 0.6 ± 0.2 mm. Each perforator supplied an average area of 26 ± 7.0 cm2. Extensive anastomoses were found between the ulnar artery perforators and multiple adjacent source arteries. (2) All flaps survived. The clinical results were satisfactory after 10.2 ± 5.3 months of follow-up. The flaps were considered cosmetically acceptable by both patients and doctors.Conclusions:The main advantage of the proximal ulnar artery perforator flap is that it is a thin flap that is ideal for upper extremity reconstruction, either as proximally or distally based local perforator flap or as a free flap. The donor site is excellent, and the vascular anatomy is very consistent.

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confidence: 99%

Vascular Anatomy and Clinical Application of the Free Proximal Ulnar Artery Perforator Flaps

Wei¹,

Shi

et al. 2014

Plastic and Reconstructive Surgery Global Open

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“…Other workers reported use of dorsal ulnar artery flap variations as the osteocutaneous flap, [6] Figure 4a: Case 3, pre-op defect of palm with dorsal ulnar artery island ß ap markings Figure 4b: Case 3, post-op result at six weeks neurocutaneous flap [3] and for different indications in hand reconstruction. [3,5,[7][8][9][10] Similarly, Niranjan and Shibu in 1994 suggested that the dorsal ulnar artery flap should only be used for the ulnar side of the lower third of the forearm and the hand. [11] Antonopoulous et al, in 1997 designed flaps up to the maximum theoretical limit of the territory supplied by the dorsal ulnar artery (20 cm long by 9 cm wide).…”

Section: Discussionmentioning

confidence: 99%

Clinical study of dorsal ulnar artery flap in hand reconstruction

Khan

Yaseen

Bariar

et al. 2009

Indian J Plast Surg

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Soft tissue defects of hand with exposed tendons, joints, nerves and bone represent a challenge to plastic surgeons. Such defects necessitate early flap coverage to protect underlying vital structures, preserve hand functions and to allow for early rehabilitation. Becker and Gilbert described flap based on the dorsal branch of the ulnar artery for defects around the wrist. We evaluated the use of a dorsal ulnar artery island flap in patients with soft tissue defects of hand. Twelve patients of soft tissue defects of hand underwent dorsal ulnar artery island flap between August 2006 and May 2008. In 10 male and 2 female patients this flap was used to reconstruct defects of the palm, dorsum of hand and first web space. Ten flaps survived completely. Marginal necrosis occurred in two flaps. In one patient suturing was required after debridement and in other patient wound healed by secondary intention. The final outcome was satisfactory. Donor areas which were skin grafted, healed with acceptable cosmetic results. The dorsal ulnar artery island flap is convenient, reliable, and easy to manage and is a single-stage technique for reconstructing soft tissue defects of the palm, dorsum of hand and first web space. Donor site morbidity is minimal, either closed primarily or covered with split thickness skin graft.

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“…Antonopoulos et al 11 reported that the territory of the fasciocutaneous flap nourished by the dorsal ulnar artery is 15 to 20 cm long and 5 to 8 cm wide; however, it is suggested that this free flap is valuable for use as a very small flap for repairing intercalated or segmental defects as a flow-through flap, for soft-tissue defects, and for revascularization in the finger.…”

Section: Discussionmentioning

confidence: 99%

Free Dorsoulnar Perforator Flap Transfers for the Reconstruction of Severely Injured Digits

Inada¹,

Tamai²,

Kawanishi³

et al. 2004

Plastic and Reconstructive Surgery

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The aim of this study was to investigate the feasibility of transferring the free dorsoulnar perforator flap nourished by the cutaneous perforator branched dorsoulnar artery to reconstruct severely injured fingers under upper arm anesthesia. Between April of 2001 and April of 2002, 13 free dorsoulnar perforator flaps were used in 13 patients. There were 11 men and two women ranging in age from 18 to 64 years, with an average age of 38 years. The affected fingers were one thumb, four index fingers, five middle fingers, two ring fingers, and one little finger. All cases were performed under upper arm anesthesia combined with intravenous local anesthesia. The operative time ranged from 103 to 140 minutes, with an average time of 120 minutes. The flap size ranged from 1 x 3 to 3 x 4 cm, and was transferred from the same forearm of the injured finger. All donor sites were closed primarily without a skin graft. The aim of reconstruction for fingers was to repair a traumatic defect (five cases), partial necrosis following replantation (two cases), and soft-tissue defects resulting from resection of a scar (three cases) and to revascularize ischemic fingers (three cases). All flaps survived completely. After repair of the flow-through circulation of the common digital artery and ischemic finger, a postoperative angiogram showed the vascular patency and hypervascularity of the reconstructed fingers, and the patients' complaints were reduced. The free dorsoulnar perforator flap under regional anesthesia is first reported; it may become one valuable option as a very small flap for the treatment of repairing intercalated or segmental defects as a flow-through flap for soft-tissue defects and ischemic fingers.

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Our Experience with the Use of the Dorsal Ulnar Artery Flap in Hand and Wrist Tissue Cover

Cited by 14 publications

References 3 publications

Vascular Anatomy and Clinical Application of the Free Proximal Ulnar Artery Perforator Flaps

Vascular Anatomy and Clinical Application of the Free Proximal Ulnar Artery Perforator Flaps

Clinical study of dorsal ulnar artery flap in hand reconstruction

Free Dorsoulnar Perforator Flap Transfers for the Reconstruction of Severely Injured Digits

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