Abdominal Pedicled Flap: Alternative for Hand Reconstruction When Microsurgery Is Not an Option

Area of Science:

• Plastic Surgery
• Reconstructive Surgery

Background:

• Dorsal hand defects pose significant reconstructive challenges, particularly when vital structures like tendons are exposed.
• Microsurgical free flaps are the standard but often inaccessible due to resource limitations.

Observation:

• A 74-year-old male patient presented with an extensive dorsal hand defect (18 cm × 12 cm) due to infection following splint use.
• The defect involved exposed tendons and fibrin deposition, necessitating urgent reconstruction.

Findings:

• A random-pattern pedicled abdominal flap was successfully transposed to cover the dorsal hand defect.
• The donor site was closed primarily, and the flap healed completely with functional recovery after pedicle division at three weeks.

Implications:

• Random-pattern pedicled abdominal flaps are a valuable alternative for upper extremity reconstruction, especially in resource-limited settings.
• This technique provides a reliable option for complex dorsal hand defects, avoiding the need for microsurgery.