Anastomosis to the common and proper digital vessels in free flap soft tissue reconstruction of the hand

Diaz-Abele, Julian; Hayakawa, Thomas E.J.; Buchel, Edward W.; Brooks, Darrell; Buntic, Rudolph; Safa, Bauback; Islur, Avinash

doi:10.1002/micr.30066

Cited by 10 publications

(12 citation statements)

References 24 publications

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“…So among the various options for reconstruction of small soft tissue defects in the ngers, the free aps have been recognized as the best reconstructive option. [1][2][3] The radial forearm ap has been rst descripted by Yang in 1978, [10] and this pedicle ap has been established its role in plastic reconstructive eld by surgeons. [13][14][15] Howerer, either free or pedicle radial forearm ap remains the main disadvantage is that the sacri ce of a major artery to the upper extremity.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the obvious limitations of pedicled aps: Bulk, colour, texture mismatch, donor morbidity, free aps have been recognized as the best reconstructive option of small digital defects. [1][2][3] Various small free aps can be harvested from thenar, forearm (including arterialised venous ap), groin, partial toe and plantar of foot to reconstruct small digital defects in clinic, [4][5][6][7][8][9] while there is not golden donor site for digital defects reconstruction using the small free ap.…”

Section: Introductionmentioning

confidence: 99%

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The Free Flap Based on a Single Proximal Perforator of Radial Artery: the Ultrasonography Study and Clinical Applications in Reconstruction of Digital Defect

Wu¹,

Zhang²,

Zhang³

et al. 2020

Preprint

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Objectives: To locate the anastomosable constant perforator of radial artery on the proximal forarm using ultrasonography, and describe the application of free radial artery flap based on a single proximal perforator in the reconstruction of digital soft tissue defects.Methods: In 20 forarms (10 right and 10 left) from 10 volunteers, the perforators in the proximal half of forarm from radial artery were visualized by ultrasonography. Then the free radial artery perforator flaps based on the single perforator were used for reconstruction of small digital soft tissue defects in 4 cases between October 2017 and May 2018.Results: Of the 20 forarms, anastomosable perforator was constantly detected from the radial artery in the proximal half of forarm. The diameter of the perforator was 0.7±0.1 mm, the pedicle length is 12±3 mm by ultrasonography. Ther location of the perforator is far from elbow crease 8.8±1.4 cm, and the relative distance of the perforator location from elbow crease to wrist crease is 37.2% ± 4.8%. In clinical cases, all the flaps were complete survival. Flap size ranged from 3.5 to 6.5 cm in length and 2.3 to 3.0 cm in width. Donor sites of forearm were closed primarily in all cases. During a mean period of 12 months (8-14 months) follow-up, the mean Brief Michigan Hand Questionnaire (BMHQ) score was 72.9 (60.4-85.4) in the affected hand.Conclusions: There is an anastomosable perforator consistent located on the radial artery in the proximal half of forarm. The free radial artery small flap based on this single perforator provides acceptable functional and cosmetic outcomes for the reconsturction of digital soft tissue defects . With the preservation of the main vessel (radial artery) of forearm, this flap provides another reliable option for handsurgery surgeon to reconstruct small digital defects.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Free Flap Based on a Single Proximal Perforator of Radial Artery: the Ultrasonography Study and Clinical Applications in Reconstruction of Digital Defect

Wu¹,

Zhang²,

Zhang³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…So among the various options for reconstruction of small soft tissue defects in the fingers, the free flaps have been recognized as the best reconstructive option. [1][2][3] The radial forearm flap has been first descripted by Yang in 1978, [10] and this pedicle flap has been established its role in plastic reconstructive field by surgeons. [13][14][15] Howerer, either free or pedicle radial forearm flap remains the main disadvantage is that the sacrifice of a major artery to the upper extremity.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the obvious limitations of pedicled flaps: Bulk, colour, texture mismatch, donor morbidity, free flaps have been recognized as the best reconstructive option of small digital defects. [1][2][3] Various small free flaps can be harvested from thenar, forearm (including arterialised venous flap), groin, partial toe and plantar of foot to reconstruct small digital defects in clinic, [4][5][6][7][8][9] while there is not golden donor site for digital defects reconstruction using the small free flap.…”

Section: Introductionmentioning

confidence: 99%

The Free Flap Based on a Single Proximal Perforator of Radial Artery: the Ultrasonography Study and Clinical Applications in Reconstruction of Digital Defect

Zhang

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: To locate the anastomosable constant perforator of radial artery on the proximal forarm using ultrasonography, and describe the application of free radial artery flap based on a single proximal perforator in the reconstruction of digital soft tissue defects. Methods: In 20 forarms (10 right and 10 left) from 10 volunteers, the perforators in the proximal half of forarm from radial artery were visualized by ultrasonography. Then the free radial artery perforator flaps based on the single perforator were used for reconstruction of small digital soft tissue defects in 4 cases between October 2017 and May 2018. Results: Of the 20 forarms, anastomosable perforator was constantly detected from the radial artery in the proximal half of forarm. The diameter of the perforator was 0.7±0.1 mm, the pedicle length is 12±3 mm by ultrasonography. Ther location of the perforator is far from elbow crease 8.8±1.4 cm, and the relative distance of the perforator location from elbow crease to wrist crease is 37.2% ± 4.8%. In clinical cases, all the flaps were complete survival. Flap size ranged from 3.5 to 6.5 cm in length and 2.3 to 3.0 cm in width. Donor sites of forearm were closed primarily in all cases. During a mean period of 12 months (8-14 months) follow-up, there were satisfactory results of digital function and cosmesis,and no functional impairments at the donor sites. Conclusions: There is an anastomosable perforator consistent located on the radial artery in the proximal half of forarm. The free radial artery small flap based on this single perforator provides acceptable functional and cosmetic outcomes for the reconsturction of digital soft tissue defects . With the preservation of the main vessel (radial artery) of forearm, this flap provides another reliable option for handsurgery surgeon to reconstruct small digital defects.

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“…Traditionally free vascularized flap transfers to the fingers connect to the proper digital artery and dorsal veins of the fingers (Diaz-Abele et al., 2018; Mersa et al., 2014; Tang et al., 2017). The veins of the fingers are predominantly located on the dorsal aspect.…”

Section: Introductionmentioning

confidence: 99%

Vascularized flap transfer to fingers with volar digital veins as recipient vessels

Chen

Wang

et al. 2019

J Hand Surg Eur Vol

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Traditionally free vascularized flap transfers to the fingers connect to the proper digital artery and dorsal veins. We report our experience using the volar digital veins as recipient veins for free vascularized flap transfers in 14 fingers of 12 patients. One or two veins (three flaps with two veins, 11 flaps with one vein) of the flap were anastomosed to volar digital veins in the recipient site. The arteries of these flaps were connected to the proper digital arteries. All the transferred flaps survived. No vessel crisis occurred. Our patients demonstrated that volar veins can be the recipient veins for free flap transfers in the fingers without increased risk of venous crisis and flap loss. Level of evidence: IV

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Anastomosis to the common and proper digital vessels in free flap soft tissue reconstruction of the hand

Cited by 10 publications

References 24 publications

The Free Flap Based on a Single Proximal Perforator of Radial Artery: the Ultrasonography Study and Clinical Applications in Reconstruction of Digital Defect

The Free Flap Based on a Single Proximal Perforator of Radial Artery: the Ultrasonography Study and Clinical Applications in Reconstruction of Digital Defect

The Free Flap Based on a Single Proximal Perforator of Radial Artery: the Ultrasonography Study and Clinical Applications in Reconstruction of Digital Defect

Vascularized flap transfer to fingers with volar digital veins as recipient vessels

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