Groin flap immobilization by axillary brachial plexus block anesthesia

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Plastic Surgery

Background:

• Pedicled groin flaps are a common method for soft tissue reconstruction in hand surgery.
• Immobilization of these flaps is crucial for successful healing, with various techniques previously described.
• Severe hand injuries often require robust soft tissue coverage, making flap viability a key concern.

Purpose of the Study:

• To evaluate the efficacy of using the motor block effect of axillary brachial plexus block for immobilizing pedicled groin flaps in hand reconstruction.
• To assess the benefits of combining axillary brachial plexus block with general anesthesia in patients undergoing groin flap surgery for severe hand injuries.

Main Methods:

• A retrospective review of 17 patients (5 female, 12 male) with severe hand injuries treated with pedicled groin flaps between 2001 and 2005.
• Patients received a combination of axillary brachial plexus block and general anesthesia.
• The motor block component of the axillary block was utilized for upper extremity immobilization during the initial recovery phase.

Main Results:

• The combined anesthesia technique successfully prevented pedicle tension and torsion during early recovery.
• A reduction in the duration of general anesthesia was observed.
• Patients experienced improved postoperative pain management.

Conclusions:

• Combining axillary brachial plexus block with general anesthesia is a preferred method for patients undergoing pedicled groin flap surgery for severe hand injuries.
• This anesthetic approach offers advantages in flap immobilization, pedicle stability, and patient comfort.
• The technique contributes to better outcomes in complex hand reconstructions requiring soft tissue coverage.