Current indications for abdominal-based flaps in hand and forearm reconstruction
| Autor: | Ryan D. Wagner, David T. Netscher, Logan W. Carr |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Microsurgery
medicine.medical_specialty Soft Tissue Injuries medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Forearm medicine.artery medicine Humans General Environmental Science 030222 orthopedics business.industry Deep Inferior Epigastric Artery Soft tissue 030208 emergency & critical care medicine Fascia Pedicled Flap Plastic Surgery Procedures Hand Surgery medicine.anatomical_structure General Earth and Planetary Sciences business Perforator Flap Groin flap Superficial circumflex iliac artery |
| Zdroj: | Injury. 51:2916-2921 |
| ISSN: | 0020-1383 |
| Popis: | Extensive soft tissue loss or injury of the hand and upper extremity is a challenging reconstructive problem traditionally treated with abdominal-based pedicled flaps. Options for coverage included the groin flap based on the superficial circumflex iliac artery, the Scarpa's fascia flap based on the superficial inferior epigastric artery, and the paraumbilical perforator flap from the deep inferior epigastric artery perforators. Despite the ability to provide consistent and pliable soft tissue coverage with ease of elevation, these flaps have several disadvantages including restriction of mobility, requirement for multiple procedures, bulkiness and patient discomfort. With the advent of microsurgery, pedicled regional flaps, and off-the-shelf skin substitutes, the applications for these flaps have narrowed. However several indications still remain. These include: patient and facility factors which deter microsurgery, the absence of recipient vessels after injury, prior surgical use of recipient vessels, the need to preserve major vessels for future reconstruction, and large multi-surface wounds requiring coverage. In this review we detail these indications and provide case examples for each. |
| Databáze: | OpenAIRE |
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