Fascial Flap Reconstruction of the Hand: A Single Surgeonʼs 30-Year Experience

Carty, Matthew J.; Taghinia, Amir H.; Upton, Joseph

doi:10.1097/prs.0b013e3181cc964c

Cited by 51 publications

(34 citation statements)

References 40 publications

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“…These tissue losses can be corrected with procedures carried out in the area of reconstructive surgery, in which the surgeons use skin flaps as the most frequent resource in the performance of their interventions. 2,3 However, necrosis continues to be the main technical complication, and can lead to treatment failure. 4 In literature, there are surveys using non-pharmacological therapeutic resources that merit special emphasis, such as acupuncture and electroacupunture 5 and polarized 6 and non-polarized low-frequency electrical currents.…”

Section: Introductionmentioning

confidence: 99%

Laser 830nm na viabilidade do retalho cutâneo de ratos submetidos à nicotina

et al. 2011

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Objective: To investigate the possible effects of laser diode 830nm counter to the action of nicotine on the viability of the skin flap in rats. Methods: 24 Wistar-albino rats were used, divided into 3 groups of 8: Group 1 -subject to the surgical technique to obtain the random skin flap in cranial base, subcutaneous injection of nicotine of 2mg/Kg/day a week before and one week after surgery and simulation of laser. Group 2 -similar to group 1, the random skin flap in the cranial base were subjected to laser irradiation immediately after surgery and on the subsequent 4 days. After euthanasia, areas of necrosis and viable tissue were examined by a manual method (weighing the Role of Feedback) and by the semi-automated method of analysis (Mini-Mop ® ). Results: The results were statistically analyzed by ANOVA. The values of the percentage of necrotic area by the method of analysis showed a decreased area of necrosis in group 2 where the laser was applied. Conclusion: The 830nm laser was effective in improving the viability of skin flaps in rats subjected to the action of nicotine. Level of evidence II: Therapeutic Studies -Investigating the results of treatment.

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Section: Introductionmentioning

confidence: 99%

Laser 830nm na viabilidade do retalho cutâneo de ratos submetidos à nicotina

et al. 2011

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“…The caliber discrepancy of pedicles with the digital artery often requires a vein graft for anastomosis, and it has more donor site morbidity, such as potential for scalp alopecia and seventh cranial nerve injury. 25 The selection of donor sites for free microvascular tissue transfer is based on the tissue deficit at the recipient site and the donor tissue characteristics. The latter consists of axial blood supply appropriate for anastomosis, availability of sensory nerve inclusion when required, and minimal donor site morbidity.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Totally Degloved Fingers With a Spiraled Parallelogram Medial Arm Free Flap

Chi

Gao

Yan

et al. 2012

The Journal of Hand Surgery

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“…As an alternative to muscle flaps, thin fascial flaps, e.g., from the temporoparietal fascia 45 or the serratus muscle 32 can be obtained in this scenario. This flap can also be used as a neurofascial flap including the auricular-temporal nerve.…”

Section: Isolated Unit (C) Defects Of the Palmmentioning

confidence: 99%

“…However, information on postoperative results regarding palmar sensation in the literature is limited. 45 The risks of hypaesthesia as well as neuroma formation in the temporoparietal region following neurotomy have to be taken into account seriously. A local, pedicled radial forearm fascial flap is a valuable alternative when there is no severe trauma to the forearm and when a reconstruction of the radial artery is possible.…”

Section: Isolated Unit (C) Defects Of the Palmmentioning

confidence: 99%

Functional resurfacing of the palm: Flap selection based on defect analysis

et al. 2011

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Extensive defect coverage of the palm and anatomical reconstruction of its unique functional capacity remains difficult. In manual laborers, reconstruction of sensation, range of motion, grip strength but also mechanical stability is required. Sensate musculo-/fasciocutaneous flaps bear disadvantages of tissue mobility with shifting/bulkiness under stress. Thin muscle and fascial flaps show adherence but preclude sensory nerve coaptation. The purpose of this review is to present our algorithm for reliable selection of the most appropriate procedure based on defect analysis. Defect analysis focusing on units of tactile gnosis provides information to weigh needs for sensation or soft tissue stability. We distinguish radial unit (r)-thenar, ulnar unit (u)-hypothenar and unit (c)-central plus distal palm. Individual parameters need similar consideration to choose adequate treatment. Unit (r) and unit (u) are regions of secondary touch demanding protective sensation. Restoration of sensation using neurovascular, fasciocutaneous flaps is recommended. In unit (c), tactile gnosis is of less, mechanical resistance of greater value. Reconstruction of soft tissue resistance is suggested first in this unit. In laborers, free fascial- or muscle flaps with plantar instep skin grafts may achieve near to anatomical reconstruction with minimal sensation. Combined defects involving unit (c) require correlation with individual parameters for optimal flap selection. Defect coverage of the palm should not consist of merely providing sensate vascularized tissue. The most appropriate procedure should be derived from careful defect analysis to achieve near to anatomical reconstruction. In laborers, defect related demands need close correlation with sensation and mechanical stability to be expected.

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Fascial Flap Reconstruction of the Hand: A Single Surgeonʼs 30-Year Experience

Cited by 51 publications

References 40 publications

Laser 830nm na viabilidade do retalho cutâneo de ratos submetidos à nicotina

Laser 830nm na viabilidade do retalho cutâneo de ratos submetidos à nicotina

Reconstruction of Totally Degloved Fingers With a Spiraled Parallelogram Medial Arm Free Flap

Functional resurfacing of the palm: Flap selection based on defect analysis

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