The posterior interosseous artery flap: Clinical results with special emphasis on donor site morbidity

Distally based subcutaneous veins for venous insufficiency of the reverse posterior interosseous artery flap

“…Some authors have highlighted poor donor site appearance, excess soft tissue, and major artery scarification as major disadvantages of RFF compared to PIAF . While we agree with the latter, donor site morbidity does not appear to be an advantage, as it leaves a scar on the dorsal side of the forearm.…”

Anatomical basis of a proximal fasciocutaneous extension of the distal-based posterior interosseous flap that allows exclusion of the proximal posterior interosseous artery

“…6 Another problem is inadvertent injury to the PIN when dissecting and ligating the PIA near its origin ( Figure 9). 8,19,20 The PIA chain-link perforator flap ( Figure 10) has some advantages in common with the traditional reverse PIA flap (Figure 9), such as good texture, simple operation, ease of survival, and no need for sacrificing the main vessels, 5,8,9,15,16,29 but it also has some unique features. First, it reduces operation time.…”

“…The PIA flap is considered to be an ideal choice to cover any skin defect over the distal forearm, wrist, hand, and fingers 8,15,29 (Figure 9). However, the technical demands of the pedicle dissection, along with the risks of ischemic necrosis and venous congestion, are considered to be major drawbacks of the flap.…”

Recurrent branch of anterior interosseous artery perforator‐based propeller flap for distal forearm injuries: Report of 2 cases

“…Donor site morbidity and cosmetic consideration are also important when planning distal forearm reconstruction. Neuwirth et al evaluated the donor site morbidity of posterior interosseous artery flaps and reported high satisfaction with the aesthetic appearance of donor sites; however, there was a difference between directly closed and grafted donor sites, with acceptance and satisfaction being lower for grafted donor sites (Neuwirth, Hubmer, & Koch, ). The recurrent branch of anterior interosseous artery perforator‐based propeller flap leaves a visible scar at the donor site, and it may require free skin graft, which may be unacceptable, especially in young female patients.…”

“…However, their solutions require complex procedures such as conversion to a free flap or anterior interosseous artery flap with dissection of the interosseous membrane. As described above, a situation in which there are no standardized salvage techniques for the impossible case of reverse ance of donor sites; however, there was a difference between directly closed and grafted donor sites, with acceptance and satisfaction being lower for grafted donor sites (Neuwirth, Hubmer, & Koch, 2013). The recurrent branch of anterior interosseous artery perforator-based propeller flap leaves a visible scar at the donor site, and it may require free skin graft, which may be unacceptable, especially in young female patients.…”