Contralateral pedicled lateral arm flap for hand reconstruction

Annals of Plastic Surgery
Siew-Weng NgWee-Teck Victor Seah

Abstract

Large defects of the hand usually require reconstruction with flap resurfacing to provide durable coverage and preserve function. Pedicled flaps are preferred when there are no vessels available or they are of questionable quality for anastomosis. Such clinical settings may be due to the primary pathology, or when the vessels are preserved for secondary reconstruction. We introduce the contralateral pedicled lateral arm flap as a viable alternative.From 1988 to 2006, we treated 22 consecutive patients aged between 6 and 70 (18 males and 4 females). The indications for flap reconstruction included hand defects resulting from trauma (n = 16), infection (n = 3), burn (n = 2), and complication of free flap (n = 1). The flap was designed with extension into the forearm and raised based on the posterior radial collateral artery. All patients underwent intensive postoperative mobilization. The flap was divided 3 weeks later after a week of ischemic preconditioning.All the flaps survived. There was no wound infection. The flap size ranged from 18 cm to 127.5 cm. Eighteen reconstructions were fasciocutaneous and 4 were osteofasciocutaneous. Three patients underwent subsequent toe-digit transfer. All patients achieved activities of daily...Continue Reading

References

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Citations

Oct 27, 2015·Hand Clinics·Brian P Kelley, Kevin C Chung
Apr 30, 2013·Annales de chirurgie plastique et esthétique·F BoucherA Mojallal
Nov 13, 2010·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Youn Hwan KimJeong Tae Kim
Aug 24, 2006·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·P KitidumrongsookK Pataradool
Jul 8, 2011·Annals of Plastic Surgery·Manzhi WongLam-Chuan Teoh
Mar 7, 2021·Annals of Plastic Surgery·Dallan DarganDavid Ralston

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