The reverse posterior interosseous flap: A solution for flap necrosis based on a review of 87 cases

Akinci, Metin; Ay, Şadan; Kamiloglu, S.; Erçetin, Ömer

doi:10.1016/j.bjps.2005.06.002

Cited by 26 publications

(19 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Such a planning provides us the opportunity to include more perforators to the flap arising from the distal portion of posterior interosseous artery and is a reliable guide for marking the distal limit of flap. Elongation of the distal border of flap (1,11) into the distal third territory for one or two centimetres, improves flap survival rates both because of the additional arterial supply by numerous perforators from posterior interosseous artery (1) and also because of the presence of rich vascular plexus in that region which improves venous drainage (11) . In our previous series of posterior interosseous flap, there was a higher overall (total and partial) flap necrosis rate (10.4%) (1).…”

Section: Discussionmentioning

confidence: 99%

“…Variations can be seen during the dissection of proximal third of forearm (1,10). Dissection is easier in the middle third of the forearm both because the vascular pedicle is more superficial and also because the terminal motor branches of radial nerve to extensor muscles already penetrate extensor muscles in the proximal third (12).…”

Section: Discussionmentioning

confidence: 99%

“…However, reverse flow posterior interosseous flap survival may be unpredictable. In order to obtain better flap survival results, we offer some modifications in flap harvest on the basis of our previous experience (1), and share the results.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Technical tips in reverse flow posterior interosseous artery flaps

Tenekeci¹,

Akinci²,

Ünal³

2017

J Turgut Ozal Med Cent

View full text Add to dashboard Cite

Objective: For avoiding contracture formation, coverage of exposed tendons, bones, nerves, joints or vascular structures, flaps are preferred over other soft tissue reconstruction techniques used in hand. Reverse flow posterior interosseous flaps as an option in hand reconstruction and the ways to obtain higher survival rates based on our experience is described and discussed in this article. Materials and Methods: From July 2003 to June 2013, 45 patients aged between 7 and 69 years (mean 34.6 years) were operated for soft tissue reconstruction of hand using distally based posterior interosseous flap. Results: Operative plan was changed ın one out of 45 flaps due to small pedicle calibre. Only one of the flaps was totally necrosed. No partial necrosis was seen. Conclusion: Reliability of posterior interosseous flaps are sometimes unpredictable due to the anatomical variability of posterior interosseous artery. We do not attempt to make pedicle dissection more proximal to the midpoint of dorsal axis line. Extension of the distal part of reverse flow posterior interosseous flap into the distal third territory is strongly recommended in every case, especially for more distant defects. By doing so, we include a piece of skin with numerious septocutaneous perforators arriving from posterior interosseous artery and their accompanying veins in the distal third region, thus obtaining higher survival rates.We believe that reverse flow posterior interosseous flaps are reliable in reconstruction of hand defects and the application of those operative techniques used in this study improve flap survival rates.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Technical tips in reverse flow posterior interosseous artery flaps

Tenekeci¹,

Akinci²,

Ünal³

2017

J Turgut Ozal Med Cent

View full text Add to dashboard Cite

show abstract

“…This may increase the risk of complications in the absence of the anastomotic arc. In an analysis of complications in 87 cases, Akinci et al 12 reported that in cases where flaps are harvested from the proximal two-thirds of the forearm requiring a long pedicle for more distal defects, distal skin of the flap should extend as far as the distal third of the forearm and should include the septocutaneous perforators in the distal third in every case. Based on all these observations, we routinely included both 2.5-cm width of adipofascial tissue and a 1-cm width of cutaneous handle in the pedicle up to the pivot point after reflecting the skin margin as a subcuticular flap.…”

Section: Dissection Of the Pediclementioning

confidence: 99%

The Reverse Posterior Interosseous Artery Flap: Technical Considerations in Raising an Easier and More Reliable Flap

Acharya

Bhat

Kumar

2012

The Journal of Hand Surgery

View full text Add to dashboard Cite

“…But, they have numerous disadvantages such as sacrificing the major artery and requiring several trimmings before a cosmetically and functionally satisfactory result is achieved. The donor site cannot be closed directly and needs skin grafts [7,8]. The posterior interosseous artery perforator flap has proved an excellent option for the coverage of soft tissue defects in digital reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Use of Free Modified Innervated Posterior Interosseous Artery Perforator Flap to Repair Digital Skin and Soft Tissue Defects

Song

et al. 2014

Indian J Surg

View full text Add to dashboard Cite

Current techniques to reconstruct soft tissue of the fingers result in scarring and functional deficits. Perforator flaps raised on the posterior interosseous artery are thin and well vascularised, and cause minimal donor site scarring. Using a flap with sensory nerves was hoped to contribute to the desired postoperative sensory recovery of fingers. We used modified innervated posterior interosseous perforator flaps to repair digital defects in 18 patients. Injuries included digit amputations and palmar soft tissue defects. The posterior antebrachial cutaneous nerve was carried in the flap and bridged with the defect section of the proper digital nerve. The flaps used measured 10 cm×6 cm to 5 cm×3 cm. All 18 flaps survived; one necrotic edge eventually healed. During the 10-28 months of follow-up (average, 14 months), twopoint discrimination in flaps and injured fingers was 6-15 mm. Good functional and sensory outcomes were obtained in primary operation, and patients were generally satisfied with the aesthetic results. Further work will be needed to assess the branches of the posterior interosseous artery preoperatively to improve surgical planning.

show abstract

The reverse posterior interosseous flap: A solution for flap necrosis based on a review of 87 cases

Cited by 26 publications

References 15 publications

Technical tips in reverse flow posterior interosseous artery flaps

Technical tips in reverse flow posterior interosseous artery flaps

The Reverse Posterior Interosseous Artery Flap: Technical Considerations in Raising an Easier and More Reliable Flap

Use of Free Modified Innervated Posterior Interosseous Artery Perforator Flap to Repair Digital Skin and Soft Tissue Defects

Contact Info

Product

Resources

About