Use of Local Sliding Flaps to Manage Deep Localized Burns of the Hand

Rahoma, Ahmed Hussein

doi:10.1007/s12593-010-0011-x

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…1 Adhesions and fibrosis may ensue, potentially compromising tendon motion. 2 Commonly used local cutaneous flaps for reconstruction of larger defects on the dorsal hand may be limited by a finite reservoir of adjacent donor skin and can lead to substantial donor site morbidity, prolonged rehabilitation, or ischemia. 1,3 A novel approach to repairing dorsal hand soft-tissue defects is proposed whereby the distinct anatomic layers of the dorsal hand anatomy are mobilized to create a vascularized sliding flap.…”

Section: Discussionmentioning

confidence: 99%

Local Fasciocutaneous Sliding Flaps for Soft-Tissue Defects of the Dorsum of the Hand

et al. 2014

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The proposed single-stage, bilevel undermined fasciocutaneous sliding flap based on the perforating vessels running through fascial septae recruits pliable, easily mobilized skin, preserves neurosensory innervation, and facilitates early hand mobilization with reduced postoperative care. This flap, and its proposed variations, are ideal for use when paratenon is exposed and immobilizing the hand would be necessary for graft survival or when tension at the wound precludes reconstruction with primary closure or a traditional flap.

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Section: Discussionmentioning

confidence: 99%

Local Fasciocutaneous Sliding Flaps for Soft-Tissue Defects of the Dorsum of the Hand

et al. 2014

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“…Local fasciocutaneous sliding flaps have been described but may result in distal hand ischemia 4,5 and a longer healing period. More invasive options include larger free or pedicled flaps, 6,7 but these require general anesthesia, prolonged healing, and are unlikely to be performed in the typical outpatient dermatologic surgery setting.…”

Section: Reconstructing the Dorsal Handmentioning

confidence: 99%

Reconstructive options for cutaneous dorsal hand defects

Neill

Roberts²,

Tolkachjov³

2021

Int J Dermatology

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Background Moderate to large dorsal hand defects pose reconstructive challenges owing to the small surface area, immobile adjacent finger tissue, and thin, fragile skin. Objective To present reconstructive options for moderate to large dorsal hand defects. Materials and methods First, a brief review of dorsal hand reconstructive options is discussed. Then, three approaches to reconstructing dorsal hand defects are presented based on the amount of available underlying tissue and location of the defect on the hand. Results In the authors' opinion, for larger defects on the mid‐distal 1st–3rd metacarpals, the single arm rotation flap is preferable. For medium‐sized defects with underlying soft tissue, a Burow's graft is appropriate. The O‐Z flap is best for medium‐ to large‐sized defects on the proximal half of the metacarpals. Defects of the digits are excluded. Conclusion The O‐Z rotation flap, single arm rotation flap, or Burow's graft can be used to reconstruct the majority of moderate to large dorsal hand defects.

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First Look: Google Glass in Dermatology, Mohs Surgery, and Surgical Reconstruction

Kantor

2014

JAMA Dermatol

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Administrative, technical, or material support: Sobanko, Fischer, Etzkorn. Study supervision: Sobanko. Conflict of Interest Disclosures: None reported. REFERENCES 1. Davami B, Porkhamene G. Versatility of local fasciocutaneous flaps for coverage of soft tissue defects in upper extremity. J Hand Microsurg. 2011; 3(2):58-62. 2. Rahoma AH. Use of local sliding flaps to manage deep localized burns of the hand. J Hand Microsurg. 2011;3(2):45-50. 3. Germann G, Biedermann N, Levin SL. Intrinsic flaps in the hand. Clin Plast Surg. 2011;38(4): 729-738. 4. Bidic SM, Hatef DA, Rohrich RJ. Dorsal hand anatomy relevant to volumetric rejuvenation. Plast Reconstr Surg. 2010;126(1):163-168. 5. Vuppalapati G, Oberlin C, Balakrishnan G. "Distally based dorsal hand flaps": clinical experience, cadaveric studies and an update. Br J Plast Surg. 2004;57(7):653-667.6. Yang D, Morris SF. Vascular basis of dorsal digital and metacarpal skin flaps. J Hand Surg Am. 2001;26 (1):142-146. 7. Quaba AA, Davison PM. The distally-based dorsal hand flap. Br J Plast Surg. 1990;43(1):28-39. 8. Bailey SH, Andry D, Saint-Cyr M. The dorsal metacarpal artery perforator flap: a case report utilizing a Quaba flap harvested from a previously skin-grafted area for dorsal 5th digit coverage. Hand (N Y). 2010;5(3):322-325. 9. Omokawa S, Tanaka Y, Ryu J, Kish VL. The anatomical basis for reverse first to fifth dorsal metacarpal arterial flaps. J Hand Surg Br. 2005;30 (1):40-44. NOTABLE NOTESTechnology continues to revolutionize the practice of dermatology, and the past decades have seen a paradigm shift in the way dermatologists practice medicine and surgery, deliver care to patients, and keep abreast of developments in our field. Google Glass (Google Inc) is a recently developed, first-in-class wearable computer that includes an optical display, camera, microphone, bone-conduction speaker, touchpad, gyroscope, and accelerometer. I have used the Google Glass device in the context of general and surgical dermatology.Applications in the clinical dermatology setting include lesional and histopathological photography, telemedicine, education, research, and consultation. Live streaming may also be used for teledermatology consultations, although store-and-forward approaches are feasible as well. Applications in the surgical setting include perioperative photography, 1 documentation of Mohs stages, Mohs specimen orientation, patient education regarding tumor and defect size and location, and reconstructive options.An advantage of this technology is the ability to activate the device in a hands-free fashion. In the surgical setting, this permits the dermatologist to record video or still photographs while maintaining a sterile field, and in the clinical setting, it permits recording photographs without the intrusion of using a camera, as photographs may be taken with a wink of the right eye.Live streaming of procedures may be used for medical and surgical education for medical students, residents, fellows, and colleagues, as well as for patient education. The dermato...

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Use of Local Sliding Flaps to Manage Deep Localized Burns of the Hand

Cited by 3 publications

References 16 publications

Local Fasciocutaneous Sliding Flaps for Soft-Tissue Defects of the Dorsum of the Hand

Local Fasciocutaneous Sliding Flaps for Soft-Tissue Defects of the Dorsum of the Hand

Reconstructive options for cutaneous dorsal hand defects

First Look: Google Glass in Dermatology, Mohs Surgery, and Surgical Reconstruction

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