Reconstruction of Circumferential Upper Extremity Defect Using a Bipedicle Expanded Flank Flap.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Tissue Expansion

Background:

• Resurfacing extensive upper extremity lesions presents challenges for plastic surgeons.
• Limitations in flap size can compromise functional and aesthetic outcomes.
• A pre-expanded flank flap was introduced to address these challenges.

Purpose of the Study:

• To evaluate the efficacy of a pre-expanded flank flap for reconstructing circumferential upper extremity defects.
• To assess functional and aesthetic outcomes, flap survival, and complication rates.

Main Methods:

• A bipedicle expanded flank flap was used in 14 patients between March 2015 and June 2019.
• The procedure involved three stages: expander implantation, flap transfer, and pedicle transection.
• Outcomes including flap survival, complications, and functional/aesthetic results were evaluated.

Main Results:

• Fourteen patients with circumferential upper extremity lesions (scars or congenital nevi) were treated.
• The average defect area reconstructed was 406.6 cm², with primary donor site closure achieved in all cases.
• Complete flap survival was observed, with only one case of seroma managed by aspiration; no marginal necrosis occurred.

Conclusions:

• The bipedicle expanded flank flap is a viable option for reconstructing circumferential upper limb skin lesions.
• This technique allows reconstruction in a single tissue expansion sequence.
• The method demonstrates a low complication rate and high patient satisfaction.