Cutaneous Anthrax of the Hand and Its Reconstruction With a Reverse-Flow Radial Forearm Flap

Çoban, Yusuf Kenan; Balik, Ozgul; Boran, Çetin

doi:10.1097/00000637-200207000-00017

Cited by 10 publications

(12 citation statements)

References 14 publications

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“…In addition to traumatic extremity injuries, flowthrough flaps have also been used for ischemic limb salvage associated with soft tissue loss due to peripheral vascular disease, 9,25,29,40 tumor reconstruction, 21 and even a defect following wide debridement for cutaneous anthrax. 10 Maloney et al describe the use of a free omental flap used in a flow-through manner for 6 patients with nonhealing extremity wounds and underlying vasculopathic conditions. 42 Although extremity reconstruction is the most common indication for flow-through flaps, they are also used in head and neck reconstruction.…”

Section: Applications Of Flow-through Flapsmentioning

confidence: 99%

“…Simultaneous transfer of vascularized bone graft or osteocutaneous flap together with forearm flap Hallock 12 Midfoot/Lower extremity peripheral vascular disease 1 Partial failure of radial forearm flap salvaged by using surviving portion as ' 'bridge' ' flap for revascularizing second free flap (gracilis) Kasten et al 13 Upper extremity trauma 1 Burt et al 62 Mid face trauma 1 Radial forearm flaps used in flow-through manner between gracilis flaps on each side and respective facial vasculature Tseng et al 8 Foot/Lower extremity trauma 1 Lateral antebrachial cutaneous n. Anastomosed to deep peroneal n. As sensate flap Libermanis et al 17 Hand trauma 2 Distally based, retrograde, radial forearm flaps for finger revascularization and soft tissue coverage Bacakoglu et al 1 Upper extremity trauma 2 Described treating delayed venous ischemia in flow-through flap using arteriovenous anastomosis Coban et al 10 Hand infection 1 Dorsal hand injury secondary to anthrax exposure Chun and Marin 9 Forefoot/Lower extremity peripheral vascular disease 2 Radial artery flow-through flap used as vascular conduit that provides venous outflow and acts as a functional modulated arteriovenous fistula Muneuchi et al 11 Lower extremity trauma 1 Radial forearm FTF used to restore soft tissue loss after replantation of leg Teodorescu et al 6 Lower extremity peripheral vascular disease 10 Composite femoral-tibial bypass graft constructed by sewing radial forearm graft to either greater saphenous vein or polytetrafluoroethylene graft Ulnar forearm Lovie et al 22 Defect in oral cavity, lower extremity, maxilla 11 Libermanis et al 17 Hand trauma 1 One-stage recon of two rays with soft-tissue defect and associated segmental defect of metacarpals and flexor tendons, nerves and arteries Posterior interosseous Shibata et al 24 Hand trauma 3…”

Section: Number Of Cases Commentsmentioning

confidence: 99%

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Flow-through flaps: A review of current knowledge and a novel classification system

et al. 2006

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Flaps have long been recognized as an essential tool for soft-tissue reconstruction. Flaps range in complexity from local to free and perforator flaps and can include a variety of composite tissues. The concept of a flow-through flap, in which both the proximal and the distal ends of the vascular pedicle of a free flap are anastamosed to provide blood flow to distal tissues, was first described by Soutar et al. in 1983. An uninterrupted arterial flow was established by Soutar et al. between the external carotid and distal facial artery via a radial forearm flap for head and neck reconstruction (Soutar et al., Br J Plast Surg 1983;36:1-8). Shortly thereafter, Foucher et al. were the first to report the reconstruction of an extremity with a simultaneous vascular defect by utilizing a radial forearm flow-through flap (Foucher et al., Br J Plast Surg 1984;37:139-148). The utility of the flow-through flap is now well established, and its indications for use continue to grow. The principle advantage of this flap is that it provides the opportunity for a single stage composite reconstruction of both soft tissue and vascular defects, making it particularly useful in the reconstruction of ischemic extremities and defects from oncologic ablations. Improvements in microsurgical equipment and techniques are making early difficulties with these flaps irrelevant, giving plastic surgeons opportunities to become more creative in the choices and uses of flow-through flaps. The literature consists mostly of case reports and series. The nomenclature used to describe the types of flow-through flaps is confusing and inconsistent. The purpose of this article is to provide an organized review of flow-through flaps and to classify these flaps based on their inflow, outflow, and the nature of their vascular conduit. Additionally, we have included a discussion on the physiology of these flaps, reviewed the current literature, and summarized the various types of flow-through flaps in a reference guide that can aid in flap selection.

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Section: Applications Of Flow-through Flapsmentioning

confidence: 99%

Section: Number Of Cases Commentsmentioning

confidence: 99%

Flow-through flaps: A review of current knowledge and a novel classification system

et al. 2006

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“…Several reports have established the ability of this flap for reconstruction of ipsilateral hand injuries. [6,7] There are appropriately 10 small perforators arising from the distal radial artery around the radial styloid process on which the flap may be based upon. Here we report a case with multiple digital degloving injuries treated with distal-based reverse radial forearm perforator flap and discuss the functional results.…”

Section: Introductionmentioning

confidence: 99%

A salvage method for multiple digital degloving injury; Wrap around degloved fingers with distal based radial forearm perforator flap

Çoban

Öcük²,

Bekircan³

2017

Ulus Travma Acil Cerrahi Derg

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Degloving hand injuries present challenging situations to hand surgeons as they present with difficulties in reconstructive microsurgery, particularly in multiple digital injuries. Time is a limiting factor when multiple degloving finger amputations are present. Thus, we proposed a repair method for multiple degloving finger injuries that involves coverage with a distal-based reverse forearm flap of all injured fingers in a two-stage procedure. Early vigorous physical therapy after pedicle division of the flap at postoperative third week eliminates joint stiffness problems at wrist and metacarpophalangeal joints.

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“…Cutaneous form is the most common and the least fatal form of the disease and it emerges due to the anthrax spores that enter the skin from scratches and wounds. It is common in developing countries, uncommon in Europe and U.S. and the reports in the literature are mostly case reports [3] [4]. It is aimed to present our anthrax series and the disease's clinical presentations.…”

Section: Introductionmentioning

confidence: 99%

Uncommon Tissue Defects of Upper Extremities: Bacillus Antracis

Akdağ¹,

Yıldıran²,

Sütçü³

et al. 2016

MPS

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Introduction: Anthrax is a zoonotic disease caused by Bacillus anthracis spores. Cutaneous form is the most common and the least fatal form of the disease, however the disease is uncommon in Europe and U.S. and the reports in the literature are mostly case reports for upper extremity. Case Series: 7 patients, who were treated between 1999 and 2015 in our clinic with the diagnosis of cutaneous anthrax in their upper extremity, were included to our study. 3 patients applied directly to plastic surgery, others were consulted from the infectious disease clinics. Reconstructions were done with skin grafts or secondarily. Discussion: Anthrax causes cutaneous, gastrointestinal and inhalation forms of the disease. Despite being very rare in Europe and US, in Turkey there are many reported anthrax cases. However, cutaneous anthrax of upper extremity is reported rarely in the literature. Painless papule and vesicles are well defined as clinical findings. In anthrax, the excision of skin lesions or biopsies is contraindicated because of the risk of systemic spread. Conclusion: Despite cutaneous anthrax of the hand and upper extremity is very rare, the diagnosis is easy because of the typical presentation and history. Once the definitive diagnosis is set, the treatment is effortless with the antibiotherapy and first steps of the reconstruction ladder.

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Cutaneous Anthrax of the Hand and Its Reconstruction With a Reverse-Flow Radial Forearm Flap

Cited by 10 publications

References 14 publications

Flow-through flaps: A review of current knowledge and a novel classification system

Flow-through flaps: A review of current knowledge and a novel classification system

A salvage method for multiple digital degloving injury; Wrap around degloved fingers with distal based radial forearm perforator flap

Uncommon Tissue Defects of Upper Extremities: Bacillus Antracis

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