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Engineered Vascularized Muscle Flap
Published on: January 11, 2016
Reverse flow flap use in upper extremity burn contractures
Fatih Uygur1, Celalettin Sever, Rahmi Evinç
1Department of Plastic and Reconstructive Surgery and Burn Unit, Gülhane Military Medical Academy and Medical Faculty, Haydarpaşa Training Hospital, Istanbul, Turkey. fatihuygur@hotmail.com
Burns : Journal of the International Society for Burn Injuries
|September 23, 2008
Summary
Reverse pedicled flaps effectively treat upper extremity burn contractures. While radial forearm and dorsoulnar flaps are reliable, medial arm flaps present venous challenges, making them less ideal for elbow reconstruction.
Area of Science:
- Plastic Surgery
- Burn Reconstruction
- Microsurgery
Background:
- Upper extremity contractures are a significant challenge for burn patients, impacting function and aesthetics.
- Surgical reconstruction is often necessary to restore range of motion and improve quality of life.
Observation:
- A series of 22 reverse pedicled flaps were analyzed for upper extremity postburn contractures.
- Specific flaps included radial forearm flaps (n=4), dorsoulnar artery flaps (n=14), and medial arm flaps (n=4).
- Indications varied: radial forearm flaps for palmar contractures, dorsoulnar flaps for hypothenar defects, and medial arm flaps for elbow contractures.
Findings:
- Reverse flow radial forearm flap (RRFF) and reverse flow dorsoulnar flap (RDUF) demonstrated smooth and efficient solutions for upper extremity reconstruction.
- The reverse medial arm flap (RMAF) experienced initial venous congestion in one case, managed with split-thickness skin grafting (STSG).
- Supercharging the RMAF by anastomosing the brachial vein to the antebrachial vein in subsequent cases resolved congestion issues.
Implications:
- RRFF and RDUF are recommended as reliable options for specific upper extremity postburn contracture reconstructions.
- RMAF presents significant venous challenges, suggesting it should not be the primary choice for elbow area reconstruction.
- Further investigation into supercharging techniques for RMAF may improve outcomes in challenging elbow contracture cases.
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