Paraumbilical Perforator-Based Pedicled Abdominal Flap for Extensive Soft-Tissue Deficiencies of the Forearm and Hand

Yilmaz, Sarper; Saydam, Mutlu; Seven, Ergin; Erçöçen, Ali Rıza

doi:10.1097/01.sap.0000154871.97860.ea

Cited by 39 publications

(36 citation statements)

References 6 publications

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“…This is in difference with previous studies done by Yilmaz et al,19 wherein majority of the patients were females which formed 72.7% of that respective study. Male preponderance in our study is because of the fact that males are more exposed to the upper limb trauma in our scenario.…”

Section: Resultscontrasting

confidence: 56%

Abdominal Flaps in the Management of Upper Limb Defect- Our Experience

Rachwani-Anil¹,

Prabhu²,

Kumar³

2017

jemds

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BACKGROUNDSoft tissue defects in upper limb are commonly seen as a sequel to trauma and burns, leading to exposure of important structures such as vessels, nerves, tendons and bone. These structures require primary cover at the earliest. Although, in the present era of microvascular reconstruction locoregional pedicled flaps are fading, abdominal flaps prove to be handy in reconstruction of upper limb soft tissue defects.The aim of this retrospective descriptive study is to prove the versatility and simplicity of abdominal flap in reconstruction of upper limb defects.

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Section: Resultscontrasting

confidence: 56%

Abdominal Flaps in the Management of Upper Limb Defect- Our Experience

Rachwani-Anil¹,

Prabhu²,

Kumar³

2017

jemds

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“…In study done in 11 patients by Sarper Yilmer studied for extensive soft tissue defects of forearm and hand showed that a relatively narrow pedicle, large flap up to 5x14 cm can be raised. 6 Comfortable position of the hand and forearm was also observed.…”

Section: Discussionmentioning

confidence: 91%

Evaluation paraumbilical flap for coverage of forearm and hand defects

Chikte¹,

Goud²

2017

Int Surg J

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INTRODUCTIONThe compound defects of the hand and forearm from electrical burns, trauma and infections are common. The reconstruction of complex wounds of hand, wrist and proximal and mid-forearm is challenging as the vital structures such as bones, tendons and joints are exposed. 1Traditional pedicled flaps are either insufficient in length ABSTRACT Background: To find out the reliability and dimensions of the pedicled paraumbilical perforator flaps to cover the compound defects of the forearm and hand. Methods: Twelve (12) patients with defects of hand, wrist, forearm and elbow are included in this study. The study period extends from August 2012 to February 2015. Patients were aged between 12-45 years. The detailed systemic examination of the patient and the local examination of the wound was carried out in all the patients. For the patients with burns, hemodynamic stabilization was done with appropriate fluid management and blood transfusions. The routine laboratory investigations were done. Results: It was a prospective study of twelve (12) cases was carried out in this study. Six men (50%) aged between 25-45 years were the commonly affected group, followed by three women (25%) aged between 35 -40 years and three children (25%), two males and one female aged between 12-17 years. Most common cause of the defect was electrical burns in seven cases (58.33%) due to accidental contact with high tension live electrical wire while at work in adults. In children it was due to accidental contact with live electric wire while they were playing. Most common site of injury was found on forearm in seven cases (58.33%), out of which left forearm was injured in five cases (41.66%) and right forearm in two cases (16.66%), followed by wrist in 2 cases (16.66%), dorsum of hand in one case (8.33%) and elbow in two cases (16.66%). All the defects were compound in nature with exposure of the tendons and bones and they were devoid of paratenon and periosteum. Conclusions: This study conclude that the paraumbilical flap is useful flap for coverage of the upper limb defects involving the hand, wrist, forearm and elbow. A fairly large flap with dimensions as large as 18 x 13 cm can be harvested. The flap is reliable with flap survival rate of 91.66%, (11 cases). There is no need to isolate the vascular pedicle, and the dissection is quick and easy. The flap and the limb remain in an elevated position and there is minimal edema and congestion postoperatively. Although the donor site scar is not concealed, as in groin flap, majority of the patients accepted the donor scar as it got concealed under the traditional dress. Thus, this flap can become workhorse for the defects of hand, wrist, proximal forearm and defects around the elbow.

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“…It is the superior oblique design that allows flap harvests of up to 30 cm in length, as opposed to the 14 cm in length described by Yilmaz, using the inferior oblique design. 9 Although these authors describe reconstructing 7 patients with forearm defects, they do not specify proximal or distal forearm location, and the pictures portray only distal forearm wounds. 9 On average, the flap is 28 cm in length and 8 cm in width, giving it a 3:1 length-to-width ratio.…”

Section: Discussionmentioning

confidence: 97%

“…9,10,[12][13][14] The different flap names reflect the skin design, feeding axial vessel, and/or use of muscle, as in the oblique rectus abdominis flap 14,15 or the extended deep inferior epigastric flap, 12,16 each used in reconstruction of various anatomic defects such as the perineum, groin, or lower extremity. Skin paddles can be oriented from the umbilicus laterally in one of several directions, similar to the spokes of a wheel, paralleling vascular anastomoses within the subdermal plexus between the dominant paraumbilical perforators and more peripheral abdominal wall or intercostal vessels.…”

mentioning

confidence: 99%