Omental Free-tissue Transfer for Coverage of Complex Upper Extremity and Hand Defects—The Forgotten Flap

Abstract

Free omental tissue transfer is a versatile reconstructive option for trunk, head and neck, and extremity reconstruction. Its utility is due to the length and caliber of the vascular pedicle and the malleability and surface area of the flap. We report our experience with omental free flap coverage of complex upper-extremity defects.

Use of the omental free flap for reconstruction of degloving hand and foot injuries: two case reports

“…The free fl ap choice depends on multiple factors such as the etiology, size and location of injury, exposure of vital structures [8], the availability of suitable recipient vessels, the wound's volume and surface area and possible donor site morbidity [3]. In cases of degloving injuries of the hand or foot the free fl ap should be large, thin, and pliable, allow tendon gliding, have rich vascular supply and offer good functional and aesthetic results [2,3].…”

“…Because of all these reasons, surgeons are trying to fi nd other ways to repair tissue defects by using microsurgical technique. One of the alternatives is the usage of the omental free fl ap [2,8]. It has special structural, functional and anatomical features that can make it a better choice for reconstruction of extensive hand or foot injuries compared to other types of fl aps [8,9].…”

“…One of the alternatives is the usage of the omental free fl ap [2,8]. It has special structural, functional and anatomical features that can make it a better choice for reconstruction of extensive hand or foot injuries compared to other types of fl aps [8,9]. The omental fl ap is thin, pliable and can be transferred to a tissue defect with poor recipient vessels because of its rich blood supply and a long vascular pedicle [8,9].…”

“…The omental fl ap is thin, pliable and can be transferred to a tissue defect with poor recipient vessels because of its rich blood supply and a long vascular pedicle [8,9]. The ischemia time of the fl ap is long due to its low metabolic demand [8]. A very important advantage is that the omentum has a large surface (its length is about 14-36 cm, width -23-43 cm and its surface can range from 300 to 1500 cm 2 [9]) therefore it can be used to cover extensive tissue defects.…”

“…A very important advantage is that the omentum has a large surface (its length is about 14-36 cm, width -23-43 cm and its surface can range from 300 to 1500 cm 2 [9]) therefore it can be used to cover extensive tissue defects. Besides, the omentum can be used as a gliding material which facilitates functions of tendons after extensive forearm tenolysis [8]. In the following section of this article we present two unique clinical cases of the patients with very extensive degloving hand and foot injuries.…”