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Updated: May 21, 2025

A Reliable Porcine Fascio-Cutaneous Flap Model for Vascularized Composite Allografts Bioengineering Studies
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Pedicled SCIA and SIEA Mega Groin Flap-A Staged Reconstructive Approach for Large Forearm Defects.

Yu-Ming Lai1, Jonathan T W Au Eong2, Bien-Keem Tan1

  • 1Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore.

Journal of Plastic and Reconstructive Surgery
|March 19, 2025
PubMed
Summary
This summary is machine-generated.

This study presents a novel technique for reconstructing upper extremity crush-degloving injuries using a bipedicled superficial circumflex iliac artery and superficial inferior epigastric artery flap. The staged inset method ensures flap survival and optimal coverage for complex forearm defects.

Keywords:
bipedicledforearm crush injuriesforearm wound reconstructionmega groin flapsuperficial circumflex iliac arterysuperficial inferior epigastric artery

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Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Reconstructive Surgery

Background:

  • Crush-degloving injuries of the upper extremity pose significant reconstructive challenges.
  • The superficial circumflex iliac artery and superficial inferior epigastric artery (SCIA-SIEA) flap offers a large vascular territory suitable for extensive defects.

Purpose of the Study:

  • To describe a technique for creating a bipedicled SCIA-SIEA flap through staged inset for upper extremity crush-degloving injuries.
  • To evaluate the efficacy and safety of this flap in reconstructing forearm defects associated with open fractures.

Main Methods:

  • A bipedicled SCIA-SIEA flap was designed and raised for reconstruction.
  • A staged inset technique was employed, initially at the wrist and progressing up the forearm over two weeks.
  • Flap delay and training were performed in two patients prior to inset.

Main Results:

  • Three patients with forearm crush-degloving injuries and open fractures underwent successful reconstruction.
  • All flaps survived without marginal necrosis.
  • Maximal flap size achieved was 25 x 15 cm, with thin elevation for optimal coverage.

Conclusions:

  • Staged insetting of a bipedicled SCIA-SIEA flap allows for primary thinning and maximal utilization of the flap.
  • This technique facilitates safe transfer and effective coverage of extensive upper extremity defects.
  • Maintaining bipedicled circulation throughout the inset process is crucial for flap viability.