DOI QR코드

DOI QR Code

Palmar Hand Wound Coverage with the Free Flaps

  • Roh, Si Young (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital) ;
  • Lee, Kyung Jin (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital) ;
  • Lee, Dong Chul (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital) ;
  • Kim, Jin Soo (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital) ;
  • Yang, Jae-Won (Department of Plastic and Reconstructive Surgery, Gangnam Jaejun Plastic Clinic for Hand and Plastic Surgery)
  • Received : 2014.11.10
  • Accepted : 2014.11.10
  • Published : 2014.11.30

Abstract

Palmar soft tissue defects are best reconstructed using a replacement flap of proper size with adequate soft tissue stability for mechanical resistance as well as with protective sensation. Reconstructive approaches are dictated by injury mechanism, defect size and location, and the status of the wound bed and tendino-skeletal structure. While uninjured portions of the hand can be used as a source for local flaps, the use of free flaps allows for maximal access for selection of the most ideal replacement tissue for the defect to be restored as close to the initial state as possible. Here, we review the garden variety of free flaps used in reconstruction of palmar soft tissue defects.

Keywords

References

  1. Lee DC, Kim JS, Ki SH, Roh SY, Yang JW, Chung KC. Partial second toe pulp free flap for fingertip reconstruction. Plast Reconstr Surg 2008;121:899-907. https://doi.org/10.1097/01.prs.0000299945.03655.0d
  2. Cho YJ, Roh SY, Kim JS, Lee DC, Yang JW. Second toe plantar free flap for volar tissue defects of the fingers. Arch Plast Surg 2013;40:226-31. https://doi.org/10.5999/aps.2013.40.3.226
  3. Yoshimura M, Shimada T, Imura S, Shimamura K, Yamauchi S. The venous skin graft method for repairing skin defects of the fingers. Plast Reconstr Surg 1987;79:243-50. https://doi.org/10.1097/00006534-198702000-00016
  4. Yan H, Fan C, Zhang f, Gao W. Arterialized venous flaps in reconstructive and plastic surgery. In: Tjoumakaris S, editor. Arteriovenous fistulas: diagnosis and management. Rijeka (Croatia): InTech; 2013. doi: 10.5772/56364.
  5. Kamei K, Ide Y, Kimura T. A new free thenar flap. Plast Reconstr Surg 1993;92:1380-4.
  6. Yang JW, Kim JS, Lee DC, Ki SH, Roh SY, Abdullah S, et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. J Reconstr Microsurg 2010;26:529-38. https://doi.org/10.1055/s-0030-1262953
  7. Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 1984;37:149-59. https://doi.org/10.1016/0007-1226(84)90002-X
  8. Koshima I, Fukuda H, Utunomiya R, Soeda S. The anterolateral thigh flap; variations in its vascular pedicle. Br J Plast Surg 1989;42:260-2. https://doi.org/10.1016/0007-1226(89)90142-2
  9. Adani R, Tarallo L, Marcoccio I, Cipriani R, Gelati C, Innocenti M. Hand reconstruction using the thin anterolateral thigh flap. Plast Reconstr Surg 2005;116:467-73. https://doi.org/10.1097/01.prs.0000173059.73982.50
  10. Buehler MJ, Pacelli L, Wilson KM. Serratus fascia "sandwich" free-tissue transfer for complex dorsal hand and wrist avulsion injuries. J Reconstr Microsurg 1999;15:315-20. https://doi.org/10.1055/s-2007-1000108
  11. Chen HC, el-Gammal TA. The lateral arm fascial free flap for resurfacing of the hand and fingers. Plast Reconstr Surg 1997;99:454-9. https://doi.org/10.1097/00006534-199702000-00021
  12. Carty MJ, Taghinia A, Upton J. Fascial flap reconstruction of the hand: a single surgeon's 30-year experience. Plast Reconstr Surg 2010;125:953-62. https://doi.org/10.1097/PRS.0b013e3181cc964c
  13. Koshima I, Urushibara K, Inagawa K, Hamasaki T, Moriguchi T. Free medial plantar perforator flaps for the resurfacing of finger and foot defects. Plast Reconstr Surg 2001;107:1753-8. https://doi.org/10.1097/00006534-200106000-00017