The forearm fillet flap: ‘spare parts’ reconstruction for forequarter amputations

Ayyala, Haripriya S.; Mohamed, Omar; Therattil, Paul J.; Lee, Edward S.; Keith, John A.

doi:10.1080/23320885.2019.1666718

Cited by 8 publications

(9 citation statements)

References 23 publications

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“…However, both patients in this study underwent resection because of recurrence, with the same poor prognosis as in other reports. 5,6,19 No local recurrence was observed in either of the 2 cases in this study, which is also similar to previous literature. Therefore, the use of fillet flaps in these patients is oncologically sound.…”

Section: Discussionsupporting

confidence: 92%

“…The possibility of recurrence due to flaps taken from distal to the tumor cannot be denied. However, both patients in this study underwent resection because of recurrence, with the same poor prognosis as in other reports 5,6,19 . No local recurrence was observed in either of the 2 cases in this study, which is also similar to previous literature.…”

Section: Discussionsupporting

confidence: 91%

“…The use of forearm fillet flaps has been reported less frequently than fillet flaps in the lower extremities, and most cases are posttraumatic 4 . Some reports suggest taking the flap as a fasciocutaneous flap to allow for increased ischemia time with decreased reperfusion injury 5,6 …”

Section: Discussionmentioning

confidence: 99%

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Soft Tissue Reconstruction Using the Free Forearm Fillet Flap in the Salvage of Forequarter Amputations for Recurrent Sarcoma

et al. 2023

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Reconstruction after radical forequarter amputation for recurrent proximal extremity sarcoma is challenging because the defect is significant, and the axillary or subclavian vessels are resected with the tumor, indicating that the pedicle of nearby flaps is often cut off. Free flaps are commonly used to cover the defect, but the donor site morbidity is problematic. Another problem with resecting the axillary or subclavian vessels is difficulty obtaining recipient vessels with matching calibers for another free flap. The authors presented 2 cases that successfully solved all these problems by covering the defects by the forearm fillet flaps.The forearm fillet flap has the advantage of using a portion that is usually discarded, so there is no donor site morbidity. Moreover, using the brachial artery as the pedicle of the flap allows the anastomosis to the stump of the resected axillary or subclavian artery because differences in caliber are slight.The use of the forearm fillet flaps has been reported less frequently than the fillet flaps in the lower extremities, and most cases are posttraumatic. In cases of trauma, complications are reported to occur in about 1 in 4 patients, but in cases after tumor resection, ischemic time can be controlled, and there are no risks of contamination or unnoticed forearm damage, so more stable results can be expected as in this report.Using the free flap from the distal portion of the resected upper limb, especially in cases with a short prognosis, is a viable option that effectively minimizes damage to the donor site and maintains quality of life.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

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Soft Tissue Reconstruction Using the Free Forearm Fillet Flap in the Salvage of Forequarter Amputations for Recurrent Sarcoma

et al. 2023

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“…Fillet flaps can be pedicled or free flaps. Fillet flaps are described more often in the literature on lower limb amputation than upper limb amputation [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Pedicled hand fillet flap to preserve stump length in below-elbow amputation

Loy

Williamson

2022

Case Reports in Plastic Surgery and Hand Surgery

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“…This can be reconstructed with skin graft, regional flaps, or free flaps from an uninvolved part of the body. The filet of the forearm free flap provides robust coverage of the amputation site with no donor site morbidity 1 . While not the standard of care, the filet flap technique is effective when primary closure is not possible if the tumor is assuredly not involving the forearm.…”

mentioning

confidence: 99%

Forequarter Amputation: Reconstruction With Targeted Muscle Reinnervation to the Filet of Forearm Free Flap

Markewych

Hansdorfer

Blank

et al. 2023

Techniques in Hand &Amp; Upper Extremity Surgery

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Forequarter amputation is a rarely indicated operation that has the potential for delayed wound healing, chronic pain, and dysfunction. Reconstruction in cases of skin and soft tissue loss may be particularly challenging. Here we present a 79-year-old female with recurrent, previously radiated left shoulder chondrosarcoma who underwent forequarter amputation with a ‘spare parts’ filet of forearm flap and targeted muscle reinnervation to the flap. The patient healed without complication and achieved reinnervation with minimal pain.

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The forearm fillet flap: ‘spare parts’ reconstruction for forequarter amputations

Cited by 8 publications

References 23 publications

Soft Tissue Reconstruction Using the Free Forearm Fillet Flap in the Salvage of Forequarter Amputations for Recurrent Sarcoma

Soft Tissue Reconstruction Using the Free Forearm Fillet Flap in the Salvage of Forequarter Amputations for Recurrent Sarcoma

Pedicled hand fillet flap to preserve stump length in below-elbow amputation

Forequarter Amputation: Reconstruction With Targeted Muscle Reinnervation to the Filet of Forearm Free Flap

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