Pedicled and Perforator Flaps in Reconstrucion of Post Trauma Defects in Upper Limbs.

Abstract

Background: Upper extremity soft tissue reconstruction is an extensive topic as a multitude of options exist for diverse soft tissue defects involving shoulder, arm, elbow, forearm, wrist, and hand. Many of the times flap cover is necessary for resurfacing exposed critical structures like tendons, neurovascular structures, bone and to provide supple tissue over joints. Pedicled and perforator flaps are seen in last years as a good choice to restore length, sensitivity and function of the injured upper limb.
 The aim of this paper is to give an overview of the definitions of as well as to present our experience regarding pedicled and perforator flaps.
 Materials and methods: A retrospective analysis of 15 trauma patients who underwent pedicled and perforator flaps during the 2012-2016 timeframe period was made. The patients were divided according to their type of injury, as well as the types of flasp that were used.
 Results: We have performed in total: 7 Foucher’s flaps, 4 Posterior Interosseous Artery flaps, 1 Radial Recurrent Artery flap, 1 Quaba flap, 1 SDMA flap. We had only two cases of partial necrosis of the flaps and all the others survived completely.
 Conclusions: Every single flap elevated successfully is linked with a meticulous surgical technique. We should take a special care in pedicle positioning because pedicle strangling was the most important negative factor in our two flap partial necrosis. Understanding the mistakes will help us to improve our surgical techniques day after day.