Superficial lateral arm flap for post-burn antecubital contractures

Area of Science:

• Plastic Surgery
• Anatomy
• Reconstructive Surgery

Background:

• Lateral arm fasciocutaneous flaps are crucial for upper limb reconstruction.
• Existing techniques may require complex vessel identification.
• A simplified approach is needed for broader clinical application.

Purpose of the Study:

• To present a novel, simplified distally based lateral arm fasciocutaneous flap.
• To investigate the vascular anatomy supplying this flap variant.
• To evaluate the clinical efficacy and reproducibility of the flap in upper limb reconstruction.

Main Methods:

• Dissection of ten fresh cadavers to delineate vascular supply.
• Identification of perforator vessels from recurrent arteries (radial, ulnar, interosseous).
• Clinical application in 12 patients with upper limb defects, including antecubital fossa contractures.

Main Results:

• The flap is reliably nourished by radial, ulnar, and interosseous recurrent arteries.
• Muscular and septocutaneous perforators were identified, supplying the flap base.
• Successful reconstruction in 12 patients demonstrated flap reliability and reproducibility.
• Dissection was straightforward, requiring no specific vessel identification or magnification.

Conclusions:

• The described distally based lateral arm fasciocutaneous flap is a reliable and reproducible option for upper limb reconstruction.
• Its simplified dissection and vascular supply make it adaptable to various surgical settings, including those with limited resources.
• The flap offers a practical solution for defects, particularly in the antecubital fossa.