Preservation of Hand Function Using Muscle Perforator Flaps

Abstract

Adequate soft tissue coverage is imperative after any interventions performed to maximize or preserve hand function. Although this can most simply be achieved by primary closure or a skin graft if possible, often a vascularized flap will be preferable, especially if a later secondary procedure is planned. Even moderately sized skin deficits of the upper extremity, and especially if involving the hand itself, can be better covered using a free tissue transfer. Many reasonable options in this regard are available. Muscle perforator flaps, as a relatively new variant of a fasciocutaneous flap, have unique attributes, including availability, diversity, accessibility, large size, and lengthy vascular pedicle, and since no muscle need be included, donor site function is preserved. As is shown here in a series of nine muscle perforator flaps in eight patients, these represent yet another alternative that should be considered if selection of a free flap is indicated to maintain hand function.

Anterolateral Thigh Adipofascial Flap for Correction of Facial Contour Deformities and Micromastia

“…anterolateral thigh (ALT) flap offers a wide range of reconstructive applications and options in the head, [2][3][4][5] neck, 2,4,6 truck 6,7 and extremities. 5,[8][9][10][11] With increased knowledge of the vascular anatomy, we anticipated that we would be able to contour the ALT adipofascial flap when reconstructing facial deformities and micromastia without sacrificing skin at the donor site. Here, we report 26 cases of free anterolateral adipofascial perforator flaps in the reconstruction of facial contour deformities and micromastia.…”