Titre
Distal Brachial Artery Perforator flap: a new chimeric option for complex hand and digits defects.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
di Summa, P.G.
Auteure/Auteur
Higgins, G.
Auteure/Auteur
Cotrufo, S.
Auteure/Auteur
Sapino, G.
Auteure/Auteur
Reekie, T.
Auteure/Auteur
Leonard, D.
Auteure/Auteur
Shaw-Dunn, J.
Auteure/Auteur
Hart, A.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1878-0539
Statut éditorial
Publié
Date de publication
2022-02
Volume
75
Numéro
2
Première page
613
Dernière page/numéro d’article
620
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Reconstruction of fingers pose unique challenges, as a thin and flexible flap is needed in order to guarantee a good functional outcome. For the first time, in this report, we present the DBAp (distal brachial artery perforator) flap, based on the distal perforator closer to the medial epicondyle. The DBAp flap was used to reconstruct complex digit defects as free flap, and to cover an elbow defect while raised as a propeller.
Four patients underwent finger reconstruction (free flaps): two patients presented an unstable finger scar following previous surgery, whereas the other two patients presented a terminalized finger at the level of the middle phalanx. A further patient presented a post-traumatic loss of substance at the elbow and was reconstructed using a perforator propeller DBAP flap.
Loss of tissues included skin and subcutaneous tissue in all patients and in one patient it included a bone component. Flap dimensions ranged from 48 to 18 cm <sup>2</sup> (average: 32 cm <sup>2</sup> ). Among complications, patient n.2 flap presented a marginal flap necrosis requiring a small skin graft after necrosis debridement.
The DBAp flap provides a slim, glabrous and pliable skin tissue with a well-hidden donor site scar and thanks to the anatomic location of the distal perforator can be designed to include a vascularized bone graft from the medial epicondyle. Despite the low number of cases, we believe that this flap should be considered as a dependable and effective source for complex reconstructions of both soft tissue and bone in fingers.
Four patients underwent finger reconstruction (free flaps): two patients presented an unstable finger scar following previous surgery, whereas the other two patients presented a terminalized finger at the level of the middle phalanx. A further patient presented a post-traumatic loss of substance at the elbow and was reconstructed using a perforator propeller DBAP flap.
Loss of tissues included skin and subcutaneous tissue in all patients and in one patient it included a bone component. Flap dimensions ranged from 48 to 18 cm <sup>2</sup> (average: 32 cm <sup>2</sup> ). Among complications, patient n.2 flap presented a marginal flap necrosis requiring a small skin graft after necrosis debridement.
The DBAp flap provides a slim, glabrous and pliable skin tissue with a well-hidden donor site scar and thanks to the anatomic location of the distal perforator can be designed to include a vascularized bone graft from the medial epicondyle. Despite the low number of cases, we believe that this flap should be considered as a dependable and effective source for complex reconstructions of both soft tissue and bone in fingers.
PID Serval
serval:BIB_CB90E40D1EF6
PMID
Date de création
2021-11-08T14:52:49.137Z
Date de création dans IRIS
2025-05-21T04:37:52Z