The Thoracoepigastric Flap: An Effective Reconstructive Method for Large Upper Extremity Defects in Low- and...

Area of Science:

• Plastic Surgery
• Trauma Reconstruction
• Microsurgery Alternatives

Background:

• Upper limb injuries frequently cause significant soft tissue loss, exposing vital structures.
• Resource-limited environments face challenges in reconstructive surgery due to equipment and expertise constraints.
• Thoracoepigastric flaps (TEFs) present a viable alternative to resource-intensive techniques for upper extremity reconstruction.

Purpose of the Study:

• To evaluate the efficacy and outcomes of Thoracoepigastric flap (TEF) reconstructions for upper extremity soft-tissue defects in a resource-limited setting.
• To assess the feasibility of TEFs as a reconstructive option for trauma patients with extensive soft tissue loss.

Main Methods:

• Retrospective analysis of patients undergoing upper extremity reconstruction with TEFs.
• Data collection included patient demographics, injury mechanisms, surgical indications, and postoperative complications.
• Single-surgeon series at a resource-limited tertiary care center.

Main Results:

• 42 patients with a mean age of 31 years underwent TEF reconstruction between 2011 and 2024.
• Patients with extensive defects required multiple surgeries and had a prolonged hospital stay.
• Flap tip necrosis requiring skin grafts was the most common complication, affecting 2 patients.

Conclusions:

• Thoracoepigastric flaps (TEFs) are advantageous in low- and middle-income countries for upper extremity reconstruction.
• TEFs do not require microsurgical expertise and provide extensive coverage for large trauma defects.
• This technique offers a reliable reconstructive option, particularly where follow-up care may be uncertain.