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Flap Reconstruction of the Hand
Jason D Wink1, Rikesh A Gandhi1, Blair Ashley1
1From the Division of Plastic Surgery and the Department of Orthopaedic Surgery, University of Pennsylvania.
Plastic and Reconstructive Surgery
|December 29, 2019
Summary
This article discusses flap reconstruction for the hand, detailing local, regional, and free flaps. It provides a framework for choosing optimal reconstruction methods based on the reconstructive ladder principle.
Area of Science:
- Plastic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- The hand possesses unique functional and aesthetic demands influencing reconstructive strategies.
- Choosing optimal reconstruction methods requires careful consideration of these hand-specific characteristics.
Purpose of the Study:
- To offer reconstructive surgeons a framework for hand reconstruction.
- To guide the selection of appropriate flap techniques for hand coverage and bone grafting.
Main Methods:
- Discussion of local, regional, and free flaps for hand reconstruction.
- Application of the "reconstructive ladder" principle for method selection.
- Algorithmic approach to identify tissue sources for vascularized coverage.
Main Results:
- Identification of reliable local and regional flaps for soft-tissue coverage and vascularized bone grafting.
- Emphasis on the reconstructive ladder: starting with simpler methods and progressing to microsurgical tissue transfer if needed.
- Consideration of unique controversies and complications in hand flap reconstruction.
Conclusions:
- Optimal hand reconstruction balances functional restoration with aesthetic considerations.
- A systematic approach, including the reconstructive ladder and flap selection, is crucial for successful hand surgery.
- Understanding flap options and potential complications is essential for practicing reconstructive surgeons.
