The pedicled thoraco-umbilical flap: A versatile technique for upper limb coverage

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Upper limb injuries often result in significant soft tissue loss, necessitating flap coverage.
• Local tissue availability for reconstruction is frequently limited, requiring distant tissue transfer.
• The thoraco-umbilical flap offers a potential solution for covering extensive upper limb defects.

Purpose of the Study:

• To evaluate the efficacy and safety of the thoraco-umbilical flap for upper limb soft tissue reconstruction.
• To assess flap survival rates, complication incidence, and donor site morbidity.
• To determine the suitability of the thoraco-umbilical flap as a primary reconstructive option.

Main Methods:

• The thoraco-umbilical flap, based on deep inferior epigastric artery perforators, was utilized in 83 patients for upper limb reconstruction.
• Patients were monitored for at least 3 weeks post-operatively for flap and donor site complications.
• Follow-up at 3-month intervals included assessment of donor site scar outcomes.

Main Results:

• The thoraco-umbilical flap achieved a high survival rate, with successful coverage in 81 out of 83 patients.
• Minor complications included marginal flap necrosis in five patients and partial flap necrosis in two patients.
• No additional procedures were required for coverage in any of the patients experiencing necrosis.

Conclusions:

• The thoraco-umbilical flap is a technically straightforward and effective method for reconstructing upper limb soft tissue defects.
• The flap offers minimal donor site morbidity and comfortable post-operative immobilization.
• It is recommended as a first-line reconstructive option for upper limb coverage due to its reliability and ease of use.