The abdomino-hypogastric flap in soft tissue reconstruction of the hand

Abstract

Background: The hand is the most frequently injured part of the human body. Extensive tissue losses of the hand have remained a big reconstructive challenge to the plastic and reconstructive surgeon. Advances in microsurgery have transformed hand reconstruction, but in the Nigerian environment limited facilities necessitate that the pedicle abdomino-hypogastric flap should remain an option. We aim at discussing the use of abdomino-hypogastric flap for hand reconstruction in our centre, and make suggestions for improvement.Method: The case records of patients with upper extremity defects treated with abdomino-hypogastric flap at the National Orthopaedic Hospital, Enugu over a six year period – January 2000 to December 2005 werereviewed. Information on bio data, presentation, management and outcome were extracted and analysed.Results: Eleven patients’ case files met the inclusion criteria. There were eight males and three females. Their ages ranged from two years to 47 years. The injuries were mainly post traumatic/crush (in five patients)and defects following release of post burns contractures (in four patients). All flaps had satisfactory survival and complications such as shoulder discomfort and a wide scar were few and well tolerated giving an overallsatisfactory outcome.Conclusion: Use of pedicled abdomino-hypogastric flap for reconstruction of upper extremity defects remains a very viable option in our environment and is recommended to those working under similarconditions of very limited resources.Key words: Abdomino-hypogastric, pedicle flap, hand defects reconstruction.