Reconstruction of the soft tissue defects of hand and wrist with ulnar artery perforator flap-presentation of case series

Authors

  • Dibyendu Das Department of Plastic Surgery, Bankura Sammilani Medical College, Bankura, West Bengal, India

DOI:

https://doi.org/10.18203/2349-2902.isj20220947

Keywords:

Soft tissue defect, Hand, Reconstruction, Ulnar artery perforator flap

Abstract

Reconstruction of soft tissue defect of hand and wrist is a common problem to plastic surgeon. I reconstructed the defect, both dorsal and palmar surface with a perforator-based flap from ulnar artery. The aim of the present study is to evaluate ulnar artery perforator flap in soft tissue defect of hand and wrist. Between January 2018 to February 2021, seven cases of skin defect were reconstructed with a perforator-based flap from ulnar artery, either pedicled or propeller type flap. The study was done at NRS medical college, Kolkata, where I have evaluated the viability of the flap, post-operative complication and patient’s satisfaction. All flaps survived, only in one case there was marginal necrosis that was treated conservatively. There was no post-operative complication, all flaps were doing well in six month and one year and one and half year follow up and patient’s satisfactions were also good. Ulnar artery perforator based fasciocutaneous flap, pedicled or propeller provides a reliable coverage of soft tissue defects of hand as well as wrist.

References

Yamakswas S. Hayashida K. Dorsal Hand Reconstruction with radial artery perforator based adipofascial flap. Plast Aesthet Res. 2020;7;24.

Andrew MHo, Chang J. Radial Artery Perforator Flap. J Hand Surg. 2010;35(2):308-11.

Zhang YT. The use of reversed forearm fasciocutaneous flap in the treatment of hand trauma and deformity (report of 10 cases). Zhonghua Zheng Xing Shaoshang Wai Ke Za Zhi. 1988;4(1):41-2.

Chang SM. The distally based radial forearm fascial flap. Plast. Reconst Surg. 1990;85(1);150-1.

Yang D, Morris SF, Tang M, Geddes CR. Reversed forearm island flap supplied by the sceptocutaneous perforator of the radial artery; anatomical basis and clinical application. Plast Resonstr Surg. 2003;112(4):1012-6.

Kanellakos GW, Yang D, Morris SF. Cutaneous vasculature of the forearm. Ann Plast Surg. 2003;50(4);387-92.

Weinzweig N, Chen L, Chen ZW. The distally based radial forearm fasciocutaneous flap with preservation of the radial artery; an anatomic and clinical approach. Plast Reconst Surg. 1994;94(5):675-84.

Koshima I, Moriguchi T, Etoh H, Tusda K, Tanaka H. The radial artery perforator based adipofascial flap for dorsal hand coverage. Ann Plast Surg. 1995;35(5);474-9.

Jeng SF, Wei FC. The distally based forearm island flap in hand reconstruction. Plast Reconst Surg. 1998;102(2):400-6.

Medalic DA. Perforator based forearm and hand adipofascial flaps for the coverage of difficult dorsal hand wounds. Ann Plast Surg. 2002;48(5):477-83.

Safak T, Akyurek M. Free transfer of radial forearm flap with preservation of radial artery. Ann Plast Surg. 2000;45(1):97-9.

Chang SM, Hou CL, Zhang F. Distally based radial forearm flap with preservation of radial artery; anatomic, experimental and clinical studies. Microsurg. 2003;23(4):328-37.

Jang HS, Lee YH, Kim MB, Chung JY, Seok GH. Fasciocutaneous propellar flap based on perforating branch of ulnar artery for soft tissue reconstruction of hand and wrist. Clin Orthop Surg. 2018;10;74-9.

Page R, Chang J. Reconstruction of hand soft tissue defects; Alternatives to the radial forearm fasciocutaneous flap. J Hand Surg. 2006;31A:847-56.

Karki D, Sing AK. The distally based island ulnar artery perforator flap for wrist defects. Indian J Plastic Surg. 2007;40:12-6.

Costa H, Soutar DS. The distally based posterior interosseous flap. Br J Plast Surg. 1988;41:221-7.

Teo TC. The propeller flap concept. Clin Plastic Surg. 2010;37:615-26.

Ignatiadis IA, Mavrogenis AF, Avram AM. Treatment of complex hand trauma using distal ulnar and radial artery perforator flaps. Injury. 2008;39(3):S116-24.

Unal C, Ozdemir J, Hasdemir M. Clinical application of distal ulnar artery perforator flap in hand trauma. J Reconstr Microsurg. 2011;27(9):559-65.

Downloads

Published

2022-03-28

Issue

Section

Case Series