Soft Tissue Reconstruction of the Hand

Friedrich, Jeffrey B.; Katolik, Leonid I.; Vedder, Nicholas B.

doi:10.1016/j.jhsa.2009.04.035

Cited by 61 publications

(37 citation statements)

References 25 publications

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“…To date, several flaps and reconstructive techniques have been employed to provide coverage for soft-tissue defects of the hand and digits 16–18 , yet choosing the ideal soft-tissue cover that gives the best functional and aesthetic outcome for a particular defect can be a challenging task (Table 1). With any type of soft-tissue reconstruction, the principal objective is to restore form, function, and sensation of the hand.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Aesthetic Outcomes of Soft-Tissue Coverage of the Hand

Rehim

Kowalski

Chung

2015

Plastic and Reconstructive Surgery

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Hand aesthetics in general and aesthetic refinements of soft-tissue coverage of the hand in particular have been increasingly considered over the past few years. Advancements of microsurgery together with the traditional methods of tissue transfer have expanded the armamentarium of the reconstructive surgeon, thus shifting the reconstructive paradigm from simply ‘filling the defect’ to reconstructive refinement to provide the best functional and aesthetic results. However, drawing the boundary between what does and what does not constitute ‘aesthetic’ reconstruction of the hand is not straightforward. The selection amongst the vast amount of currently available reconstructive methods and the difficulties in objectively measuring or quantifying aesthetics has made this task complex and rather arbitrary. In this article we divide the hand into several units and subunits to simplify our understanding of the basic functional and aesthetic requirements of these regions that may ultimately bring order to complexity.

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Section: Introductionmentioning

confidence: 99%

Enhancing Aesthetic Outcomes of Soft-Tissue Coverage of the Hand

Rehim

Kowalski

Chung

2015

Plastic and Reconstructive Surgery

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“…The texture of the medialis pedis and medial plantar flaps matches that of the original fingers . Free flaps from other regions are too bulky for use in the fingers, where they interfere with finger motion and restrict the range of motion. Furthermore, both the medialis pedis flap and the medial plantar flap provide glabrous skin and reduce unsightly scarring on the donor site, which is preferable from an esthetic perspective …”

Section: Discussionmentioning

confidence: 92%

“…Such independence may facilitate postoperative exercise, allowing more satisfactory results for range of motion of the fingers. In addition, bulky flaps obstruct the postoperative range of motion of reconstructed fingers; therefore, thin flaps are desirable in soft tissue reconstruction …”

mentioning

confidence: 99%

Combined medialis pedis and medial plantar fasciocutaneous flaps for coverage of soft tissue defects of multiple adjacent fingers

et al. 2014

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Soft tissue defects of adjacent multiple fingers covered by a single large flap require secondary separation of the flap into each finger. Such covering obstructs independent motion of injured fingers until the single large flap is separated. This report describes the technique of combined medialis pedis and medial plantar fasciocutaneous flaps for reconstructing soft tissue defects of multiple adjacent fingers. Three male patients (age range, 18-33 years) underwent soft tissue reconstructions of multiple adjacent fingers with combined flaps. Injuries involved three adjacent palmar fingers, two adjacent palmar fingers, and two adjacent dorsal fingers. Average sizes of the combined flaps were 4.2 × 4.0 cm for the medialis pedis flap and 3.0 × 1.8 cm for the medial plantar fasciocutaneous flap. All flaps survived without vascular complications, and donor sites healed uneventfully. All patients experienced excellent recovery of range of motion for the reconstructed fingers. In conclusion, combined flaps may offer an alternative for coverage of soft tissue defects that involve multiple adjacent fingers.

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“…There is no flap, however, that provides a solution to all problems. 1,22 Local flaps have limited application, for there is little expendable donor tissue for large defect coverage, especially in the hand. An exception is the upper arm, for which the latissimus dorsi muscle flap is indicated.…”

Section: Discussionmentioning

confidence: 99%