The Role of Fabricated Chimeric Free Flaps in Reconstruction of Devastating Hand and Forearm Injuries
| Autor: | Andreas B. Schmidt, Michael Pelzer, Goetz A. Giessler, Guenter Germann |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Forearm injury business.industry medicine.medical_treatment Forearm Injuries Hand Injuries Free flap Middle Aged Plastic Surgery Procedures Free Tissue Flaps eye diseases Surgery Free fibula Lateral arm flap medicine Passive motion Humans Gracilis muscle Head and neck business Reduction (orthopedic surgery) |
| Zdroj: | Journal of Reconstructive Microsurgery. 27:567-574 |
| ISSN: | 1098-8947 0743-684X |
| Popis: | Devastating hand and forearm injuries almost exclusively need free flap transfer if reconstruction is attempted. Early active and passive motion is only possible with aggressive, early, and comprehensive reconstruction. Despite recent advances in compound flaps, in selected cases it might be wise to harvest several smaller flaps and microsurgically combine them to one "chain-linked" flap "system." Four microsurgically fabricated chimeric free flaps were used in four patients for complex hand and forearm injuries. The combinations were sensate anterolateral thigh (ALT) flap plus sensate extended lateral arm flap (2x), ALT plus free fibula, and ALT plus functional musculocutaneous gracilis muscle. All flaps survived completely. Functional rehabilitation was possible immediately after flap transfer. There were no donor-site complications except two widened scars. The microsurgical fabrication of chimeric free flaps, as well established in head and neck reconstruction, can be successfully adapted to massive hand injuries as well. Individual placement of selected tissue components, early comprehensive reconstruction, and reduction of the number of operations are beneficial in cases that need more than one free flap. |
| Databáze: | OpenAIRE |
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