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Use of Bilobed Perforator Flaps for Dorsoradial Hand Defects Resulting From Tumor Excision
Burak Özkan1, Burak Ergün Tatar1, Yusuf Yahşi2
1Department of Plastic, Reconstructive and Aesthetic Surgery, Medipol University, Istanbul, Turkey.
Microsurgery
|January 5, 2026
Summary
Bilobed perforator flaps offer a reliable solution for dorsal hand reconstruction after tumor removal. This technique provides good functional and cosmetic results with manageable complications.
Area of Science:
- Plastic Surgery
- Hand Reconstruction
- Reconstructive Microsurgery
Background:
- Dorsal hand defects present significant reconstructive challenges due to complex anatomy.
- Existing methods like skin grafts and local flaps have limitations.
- Bilobed flaps, successful in nasal reconstruction, are underutilized for dorsal hand defects.
Purpose of the Study:
- To evaluate the efficacy of bilobed perforator flaps for reconstructing dorsal hand defects.
- To assess functional and aesthetic outcomes of this technique.
- To determine the safety and potential of bilobed flaps in hand surgery.
Main Methods:
- Retrospective analysis of 16 patients with dorsal hand defects post-tumor excision (2016-2021).
- Reconstruction utilized bilobed perforator flaps, excluding patients with specific comorbidities.
- Outcomes assessed via defect/flap size, complications, Michigan Hand Outcomes Questionnaire (MHQ), and Vancouver Scar Scale (VSS).
Main Results:
- Average patient age was 55.63 years; squamous cell carcinoma was most common.
- Mean defect size was 4.31 cm², with an average follow-up of 16.06 months.
- Satisfactory aesthetic and functional outcomes reported, with minor complications successfully managed.
Conclusions:
- Bilobed perforator flaps are a reliable option for dorsal hand reconstruction.
- The technique offers functional, cosmetic benefits, and minimal donor site morbidity.
- This flap is a promising alternative for selected patients, expanding its application beyond nasal reconstruction.
