Posterior Interosseous Flap versus Reverse Adipofascial Radial Forearm Flap For Soft Tissue reconstruction Of Dorsal Hand Defects

Akdağ, Osman; Yıldıran, Gökçe; Sütçü, Mustafa; Karameşe, Mehtap

doi:10.5505/tjtes.2017.41196

Cited by 19 publications

(20 citation statements)

References 13 publications

(23 reference statements)

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“…[36] As to the donor site scar, patient and parent satisfaction is at an acceptable level in our series and to support this point; it has been reported in the literature that PIO flap is an acceptable option according to the other flap alternatives in which the forearm is used as a donor site. [29] Although there have been reports of temporal motor paralysis due to posterior interosseous nerve damage in the literature, no patient in our series had a wrist drop or similar complication due to a PIN wound.…”

Section: Discussionmentioning

confidence: 55%

“…It has been reported that the planning of the flap skin island to reach the 1/3 distal of the forearm would reduce venous congestion. [29] Sonmez et al reported an alternative solution for venous congestion in a superficial vein anastomosis added to the PIO flap. [30] Furthermore, Nikkhah et al reported in his study that small technical manoeuvres had been conducted for the safe removal of the flap.…”

Section: Discussionmentioning

confidence: 99%

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Versatile Use Of 'The Posterior Interosseous Flap' In The Reconstruction Of Complex Upper Limb Defects

Barin

Çinal

Kara³

et al. 2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Reconstruction of the complex upper extremity defects is a challenging procedure for reconstructive surgeons because of the complex anatomical and functional structure of this region. In reconstruction, local and regional flap options involving the composite tissues are restricted. The posterior interosseous flap (PIO) has been presented "in a single study" with a wide variety of uses, and in this study, the versatility of PIO has been tried to be emphasized by its multitude uses as well as its chance at adaptability to each case. Hence, due to this, the objective to highlight the versatile utility of the PIO flap in clinical practice and to present a good option for the reconstruction of complex upper limb defects for various cases have been targeted. METHODS: We used 26 PIO flaps in 25 patients (18 male and seven female patients) with upper limb defects. The main etiological causes were burn contracture, traffic accident, firearm and acute burn injury. Twenty-two flaps were harvested as fasciocutaneous and four flaps as osteo-fasciocutaneous manner, which were applied to the metacarpal defects. In this study, 25 flaps were transferred as pedicled flaps, of which 23 and 2 flaps had reverse and antegrade blood flows, respectively, whereas one flap was used as a free flap. RESULTS: The mean follow-up period was 14 months. All flaps except one, which had partial necrosis and secondary healed, survived completely. All patients were able to gain basic functions for daily routine activities in the late postoperative period. Patients and/ or their parents were satisfied with the postoperative functional and aesthetic improvements. CONCLUSION: Many advantages of the PIO flap make it useful for the reconstruction of upper limb complex defects. It can be versatilely used based on changing its flow direction and enrichment of contents.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Versatile Use Of 'The Posterior Interosseous Flap' In The Reconstruction Of Complex Upper Limb Defects

Barin

Çinal

Kara³

et al. 2019

Ulus Travma Acil Cerrahi Derg

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“…9 The venous drainage is carried out through the venae comitentes of the radial artery. 10 In our study we report our experience of reverse radial forearm flap on various defects of hand and wrist without necessitating the use of a option in all these cases. Allen's test was performed preoperatively to confirm the continuity of palmar arch.…”

Section: Introductionmentioning

confidence: 95%

Reverse Radial Forearm Flap

Hyder¹,

Zulfiqar²

2018

TPMJ

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Objectives: To highlight the usefulness of reverse radial forearm fasciocutaneous flap in covering various soft tissue defects of hand and wrist. Study Design: Descriptive, experimental study. Setting: Department of Plastic & Reconstructive Surgery, Dow University of Health Sciences & Dr Ruth KM Pfau Civil Hospital Karachi. Period: December 2016 to January 2018. Material & Methods: A total of 16 reverse radial forearm flaps were utilizedto cover various soft tissue defects of hand and wrist from various etiologies including road traffic accidents, mechanical trauma, and industrial trauma and fireworks injuries were included. Patients with segmental bone loss and those patients having partial of complete amputation of thumb were excluded. The age ranged from 18 – 45 (mean 29.25) years. Soft tissue defects of dorsum were covered with this flap in 8 cases, 4 cases on palmer aspect and 2 cases for transmetacarpal level and 1st web space defects each. Donor site was covered with split skin graft in all cases. Patients were followed for at least three months postoperatively. Results: We had partial loss of flap in two cases which was managed with debridement and skin grafting. Superficial epidermolysis was found in one case and managed conservatively. Donor site was skin grafted in all cases which was healed uneventfully and quite acceptable to the patients in due course of time. Conclusion: Reverse radial artery flap has a quite long arc of rotation, which brings it great ease to cover the soft tissue defects of various areas of hand like palm, dorsum and first web space.

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“…Many options have been described to repair these defects and aim to preserve the function and maintain the native color and texture. (Akdag, Yildiran, Sutcu, & Karamese, ; Karamese, Akatekin, Abac, Koplay, & Tosun, ; Liu, Wang, Li, & Du, ; Rehim, Kowalski, & Chung, )…”

Section: Introductionmentioning

confidence: 99%

The V‐Y advancement flap based on the dorsal carpal perforators for dorsal metacarpal reconstruction: Anatomical and clinical study

Chen

Zhang

et al. 2020

Clinical Anatomy

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Introduction: Soft-tissue defects on the dorsal hand accompanied by exposed bone and tendon remain a challenge for plastic surgeons. The purpose of this study was to observe the morphological characteristics of the dorsal carpal perforators in the wrist and to design a V-Y advancement flap based on the dorsal carpal perforators. Materials and Methods: Thirty cadaveric hand specimens were dissected to observe the origin, course, branches, and anastomoses of the dorsal carpal perforators, and a V-Y advancement flap was designed based on these perforators. Clinically, nine cases of dorsal hand defects were reconstructed with this flap. Results: The dorsal carpal vascular network was formed by vascular anastomoses along the dorsal carpal branch of the radial artery, dorsal carpal branch of the anterior interosseous artery, ascending branch of the dorsal carpal perforator from the deep palmar arch, direct branch of the radial artery, dorsal carpal branch of the ulnar artery, posterior interosseous artery, and deep palmar branch of the ulnar artery; this network could be divided into a deep vascular network and superficial vascular network according to the anatomical plane. Among the perforators, the third and fourth perforators that pierce out bilaterally from the tendon of the extensor digitorium had a consistent occurrence rate (100%) with an outer diameter of 0.7 ± 0.3 mm and 0.6 ± 0.2 mm, respectively, and thus could be chosen as the vascular pedicle. In clinical applications, all flaps survived completely with excellent color and texture, a satisfactory appearance, and normal movement of the wrist joint. Conclusions: A V-Y advancement flap based on the dorsal carpal perforators can become a useful choice for the repair of dorsal metacarpal defects caused by trauma or dorsal metacarpal arterial flaps.

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Posterior Interosseous Flap versus Reverse Adipofascial Radial Forearm Flap For Soft Tissue reconstruction Of Dorsal Hand Defects

Abstract: BACKGROUND: Our objective was to compare the outcomes of dorsal hand defect reconstruction using a posterior interosseous artery flap (PIAF) and a reverse adipofascial radial forearm flap (RARFF).

Cited by 19 publications

References 13 publications

Versatile Use Of 'The Posterior Interosseous Flap' In The Reconstruction Of Complex Upper Limb Defects

Versatile Use Of 'The Posterior Interosseous Flap' In The Reconstruction Of Complex Upper Limb Defects

Reverse Radial Forearm Flap

The V‐Y advancement flap based on the dorsal carpal perforators for dorsal metacarpal reconstruction: Anatomical and clinical study

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