Distally based posterior interosseous adipofascial flap with delayed skin grafting for soft-tissue reconstruction of the dorsal hand

Abstract

Objective To investigate the clinical results of reverse interosseous adipofascial flap with delayed skin grafting in the reconstruction of defects on the dorsal hand. Methods From March 2012 to May 2014, 16 patients with soft tissue defects on the dorsum of the hand were treated dorsal interosseous adipofascial flap in emergency setting. The size of the flaps ranged from 5 cm×4 cm to 10 cm×6 cm. The donor site at the forearm was closed directly. Seven days later, the fascial flap was covered with a full-thickness skin graft taken from the groin area. Vancouver Scar Scale was applied to assess the donor site scar. Five-point Likert scale was used to evaluate the appearance of the recipient site. Results One patient had partial loss of the flap involving 5% of the area at the distal end. All the other flaps survived completely. The skin grafts took well in all 16 patients. The duration of postoperative follow-up ranged from 6 to 12 months, with an average of 8 months. The texture and color of the skin graft were good, and the esthetic result was satisfactory. The mean score of Vancouver Scar Scale was 0.8. The mean score of Five-point Likert scale was 17. Conclusion The described adipofascial flap transfer with delayed skin graft is rather easy to perform without causing significant functional and aesthetic deficits to the donor site. It is a good method for repairing defects of the dorsal hand. Key words: Hand injuries; Treatment ontcome; Adipofascial flap; Posterior interosseous artery