Reconstruction of finger composite defects with perforator free flap from the superficial palmar branch of radial artery

Abstract

Background: Relatively rare scarce number of flaps are used to repair composite defects occurring as a consequence of finger injuries. The main objective in this study is reconstruction of the composite defects of the fingers to share in our study; we aimed to transfer our the experience with the use of the free perforator flap of the radial artery superficial palmar branch (SUPBRA). Materials and Methods: A total of 10 (three women and seven men; age between range, 18 and 47 years) patients who had undergone free composite SUBPRA flap reconstruction, operations between 2010 and 2013 were included in the study. Defect sizes ranged between from 2 cm × 3 cm to 3 cm × 5 cm. The patients were followed up postoperatively for a median an average period of 11.5 (six‑18 months) months. All patients were assessed with static and dynamic two‑point discrimination tests, Semmes‑Weinstein monofilament test, cold intolerance test, time of returning to work, the active total range of motion of the injured fingers, cosmetic appearance of the donor/recipient sites and were also assessed for neuroma the development of neuroma on the donor site. Results: All composite free flaps survived completely, and the follow‑up duration was 11.5 months. The average median operative time was 194 min (180–260 min) and the patients returned to their work their normal life after an average of 13 weeks (11–21). Any complication concerning with donor sites and wrist movements when primary closures were performed was observed. Conclusion: Free SUBPRA flap can be elevated from ipsilateral extremity under regional anesthesia which can be easily used for the reconstruction of composite defects with an advantage of providing a relatively hairless and thinner coverage. Therefore, it can be a perfect alternative for the repair of composite tissue defects encountered in the practice of hand surgery. Keywords: Composite defect, finger injuries, free flap, SUBPRA