Clinical study of dorsal ulnar artery flap in hand reconstruction

Abstract

Soft tissue defects of hand with exposed tendons, joints, nerves and bone represent a challenge to plastic surgeons. Such defects necessitate early flap coverage to protect underlying vital structures, preserve hand functions and to allow for early rehabilitation. Becker and Gilbert described flap based on the dorsal branch of the ulnar artery for defects around the wrist. We evaluated the use of a dorsal ulnar artery island flap in patients with soft tissue defects of hand. Twelve patients of soft tissue defects of hand underwent dorsal ulnar artery island flap between August 2006 and May 2008. In 10 male and 2 female patients this flap was used to reconstruct defects of the palm, dorsum of hand and first web space. Ten flaps survived completely. Marginal necrosis occurred in two flaps. In one patient suturing was required after debridement and in other patient wound healed by secondary intention. The final outcome was satisfactory. Donor areas which were skin grafted, healed with acceptable cosmetic results. The dorsal ulnar artery island flap is convenient, reliable, and easy to manage and is a single-stage technique for reconstructing soft tissue defects of the palm, dorsum of hand and first web space. Donor site morbidity is minimal, either closed primarily or covered with split thickness skin graft.