TY - JOUR
T1 - Free flaps as flow-through vascular conduits for simultaneous coverage and revascularization of the hand or digit
AU - Brandt, Keith
AU - Khouri, Roger K.
AU - Upton, Joseph
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1996/8
Y1 - 1996/8
N2 - In complex extremity injuries, which include volar skin loss and ischemic digits, simultaneous coverage and revascularization are required. In this series of 12 patients, free-tissue transfers were utilized to provide both soft-tissue coverage and a flow-through arterial conduit for revascularization. Eleven cases involved the hand or digits, and one case involved the great toe. Six cases were performed for acute ischemia associated with traumatic soft-tissue loss. The remaining six flaps were utilized to lengthen contracted vascular pedicles and provide vascularized soft-tissue coverage during reconstruction of severe hand and foot contractures. Nine temporoparietal fascia free flaps were used for hand or digit revascularization. Two fillet flaps were created, one from a nonreplantable foot and another from an isolated index amputation. The distal end of the axial artery of the flap was anastomosed to a digital artery to restore circulation. Fascial flaps were covered with full-thickness skin grafts. Primary wound healing was achieved in all patients. There were no flap losses or other complications. All the distal parts were revascularized adequately by the axial arteries of the flaps, and functional recovery was good. In this technique, the flap satisfied the need for both coverage and revascularization. Vein grafts were not needed. This series further describes the utility of flow-through flaps in the revascularization of digits.
AB - In complex extremity injuries, which include volar skin loss and ischemic digits, simultaneous coverage and revascularization are required. In this series of 12 patients, free-tissue transfers were utilized to provide both soft-tissue coverage and a flow-through arterial conduit for revascularization. Eleven cases involved the hand or digits, and one case involved the great toe. Six cases were performed for acute ischemia associated with traumatic soft-tissue loss. The remaining six flaps were utilized to lengthen contracted vascular pedicles and provide vascularized soft-tissue coverage during reconstruction of severe hand and foot contractures. Nine temporoparietal fascia free flaps were used for hand or digit revascularization. Two fillet flaps were created, one from a nonreplantable foot and another from an isolated index amputation. The distal end of the axial artery of the flap was anastomosed to a digital artery to restore circulation. Fascial flaps were covered with full-thickness skin grafts. Primary wound healing was achieved in all patients. There were no flap losses or other complications. All the distal parts were revascularized adequately by the axial arteries of the flaps, and functional recovery was good. In this technique, the flap satisfied the need for both coverage and revascularization. Vein grafts were not needed. This series further describes the utility of flow-through flaps in the revascularization of digits.
UR - http://www.scopus.com/inward/record.url?scp=0030014758&partnerID=8YFLogxK
U2 - 10.1097/00006534-199608000-00018
DO - 10.1097/00006534-199608000-00018
M3 - Article
C2 - 8764721
AN - SCOPUS:0030014758
SN - 0032-1052
VL - 98
SP - 321
EP - 327
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 2
ER -