Perforator-Based Reverse Radial Adipofascial Forearm Flap to Reconstruct Palmar Traumatic Defect
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 1, Pages 2099-2105
AbstractAdequate soft tissue coverage is a corner stone for successful hand reconstruction in traumatic patients allowing for hand mobilization and rehabilitation. In this case report, a modified application of reverse radial adipofascial forearm flap for the simultaneous reconstruction of the palm for traumatic defect is presented. The patient was a 42- year-old man with a history of right palmar avulsion trauma in a car accident. Initially, the patient underwent skin grafts twice, but the symptoms did not improve. Then a distally based reverse radial adipofascial forearm flap with a dimension 15*7cm was planned. The flap was transposed to the palmar defect. After the flap is inserted, the donor defect was closed primarily. After 5 days, the patient underwent a split thickness skin graft to cover the flap. After surgery, a satisfactory coverage is observed in the recipient area. Although, longer time will be needed for complete evaluation of hand function but in early post operative period hand function and pain improved with compared to pre operative time. The advantages of this proposed technique are better donor site morbidity, easy implementation, simultaneous coverage of complex defects, primary closure of donor site, avoidance of long-term immobilization and related complication such as shoulder and elbow stiffness, bad hygiene and avoidance of microsurgery and shorter surgery time.
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