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Related Experiment Video

Updated: Dec 26, 2025

An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps
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An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps

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Current indications for abdominal-based flaps in hand and forearm reconstruction.

Ryan D Wagner1, Logan Carr2, David T Netscher3

  • 1Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, United States.

Injury
|March 11, 2020
PubMed
Summary

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Abdominal-based pedicled flaps remain valuable for hand and upper extremity reconstruction when microsurgery is not feasible. This review details specific indications where these traditional flaps offer essential soft tissue coverage.

Area of Science:

  • Reconstructive surgery
  • Microsurgery
  • Hand surgery

Background:

  • Extensive soft tissue loss in the hand and upper extremity presents significant reconstructive challenges.
  • Abdominal-based pedicled flaps (groin, Scarpa's fascia, paraumbilical perforator) have been traditional treatment options.
  • These flaps offer pliable coverage but have drawbacks like limited mobility and bulkiness.

Purpose of the Study:

  • To review the remaining indications for abdominal-based pedicled flaps in hand and upper extremity reconstruction.
  • To highlight scenarios where advanced techniques like microsurgery are not suitable or available.
  • To provide case examples illustrating these specific indications.

Main Methods:

  • Review of existing literature on abdominal-based pedicled flaps for upper extremity reconstruction.
Keywords:
Groin flapPedicled flapScarpa's fascia flapUpper extremity reconstruction

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Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
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  • Analysis of specific clinical scenarios where these flaps are still indicated.
  • Presentation of illustrative case examples.

    • Main Results:

    • Microsurgery, regional flaps, and skin substitutes have reduced the use of abdominal flaps.
    • Key indications persist, including patient/facility factors precluding microsurgery, absent recipient vessels, prior vessel use, vessel preservation needs, and large multi-surface defects.
    • Case examples demonstrate successful application in these specific scenarios.

    Conclusions:

    • Abdominal-based pedicled flaps retain a crucial role in specific, complex hand and upper extremity reconstructions.
    • Their continued utility is demonstrated in situations where advanced reconstructive options are limited or contraindicated.
    • Understanding these niche indications is vital for comprehensive reconstructive planning.