Regional Perforator Flaps for Coverage of Complex Wounds in Upper Limbs

Khater, Amr M. E.; El Hadidy, Mohamed R; Younes, Reda A

doi:10.21608/ejprs.2023.284331

Regional Perforator Flaps for Coverage of Complex Wounds in Upper Limbs

Document Type : Original Article

Authors

The Department of Plastic Surgery, Faculty of Medicine, Mansoura University

10.21608/ejprs.2023.284331

Abstract

Introduction: Reconstruction of complex wounds in the
upper limbs is a difficult task as multiple structures, including
nerves, blood vessels and tendons are arranged in a relatively
small soft tissue envelope with limited options available for
reconstruction. Early dtection and proper mangemnt of vascular
compromise of perforator flaps is key for success of these
reconstructive surgeries.
Aim: Evaluating of perferator flaps to cover upper limbs
wounds.
Patients and Methods: Twenty-four cases were included
in this study. After wound debridement, fasciocutaneous flaps
nourished by perforator vessels were used for coverage in
these patients. All patients were followed-up for at least 12
months.
Results: Twenty-three patients were males, and one patient
was female. The age ranged from 9 to 55 years. All flaps
survived completely except one flap which showed partial
necrosis. Within 12 hours after surgery, temporary venous
congestion was observed in 2 cases. Conservative measures
could resolve venous congestion with flaps' survival. Followup < br />showed excellent contour of the flaps with stable coverage.
Regional perforator flaps included in this study was radial
artery perforator flaps (8 cases), ulnar artery perforator flaps
(6 cases), posterior interosseous artery perforator flaps (8
cases) and lateral arm flap (one case).
Conclusion: Perforator-based flaps provide stable wound
coverage with low cost and low morbidity rate for coverage
of complex wounds in the upper limb. Careful and meticulous
technique and early detection of venous congestion is critical
for survival of these flaps.

Keywords

Main Subjects

Hand and Upper Limb Surgery'

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