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Procurement and Perfusion-Decellularization of Porcine Vascularized Flaps in a Customized Perfusion Bioreactor
Published on: August 1, 2022
Reverse radial forearm flap peforator used in digital revascularization
Steven Lo1, Sandeep Sebastin, Larry Tsai
1Department of Hand and Reconstructive Microsurgery, National University Hospital, Lower Kent Ridge Road, Singapore, Singapore, stevenjlo@gmail.com
Hand (New York, N.Y.)
|September 10, 2008
Summary
This study introduces a novel technique using a radial artery perforator from a reverse radial forearm flap for digital revascularization in severe hand trauma. This method addresses both tissue defects and devascularization, offering a single solution for complex injuries.
Area of Science:
- Microsurgery
- Hand Surgery
- Vascular Surgery
Background:
- Complex hand trauma often involves devascularization and soft tissue defects.
- Existing treatments like vein grafts and local flaps may fail or be insufficient.
- Revascularizing distant tissue with pedicled flaps is rarely reported.
Purpose of the Study:
- To describe the first use of a radial artery perforator from a reverse radial forearm flap for digital revascularization.
- To present an innovative solution for severe hand crush injuries with combined digital devascularization and palmar defects.
- To demonstrate overcoming "zone of injury" challenges in complex hand trauma.
Main Methods:
- A reverse radial forearm flap was employed for soft tissue coverage of a palmar defect.
- A radial artery perforator was isolated from the flap for direct digital revascularization.
- This single-stage procedure addressed both vascular supply and tissue defect.
Main Results:
- Successful revascularization of a devascularized digit was achieved.
- Simultaneous coverage of a palmar soft tissue defect was accomplished.
- The technique effectively managed the "zone of injury" in a complex hand trauma case.
Conclusions:
- A radial artery perforator from a reverse radial forearm flap is a viable option for digital revascularization in specific complex hand trauma scenarios.
- This technique offers a single-stage solution for combined digital revascularization and soft tissue defect coverage.
- It provides an alternative to repeated or less effective reconstructive methods in challenging hand injuries.
