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Distal dorsal forearm flap

S A Syed1, K S Zahir, J R Zink

  • 1Section of Plastic Surgery, Yale University School of Medicine, New Haven, CT 06520-8041, USA.

Annals of Plastic Surgery
|April 1, 1997
PubMed
Summary
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A new skin flap for hand reconstruction can be designed using the anterior interosseous artery's perforating vessels. This study explored the vascular supply of the distal dorsal forearm for flap feasibility.

Area of Science:

  • Anatomy
  • Plastic Surgery
  • Microsurgery

Background:

  • Reconstruction of the dorsal hand often requires versatile flaps.
  • The anterior interosseous artery (AIA) is a potential source for flap vascularity.

Purpose of the Study:

  • To investigate the vascular anatomy of the distal dorsal forearm.
  • To assess the feasibility of a local skin flap based on the AIA for dorsal hand reconstruction.

Main Methods:

  • Anatomical dissection of 71 fresh-frozen cadaveric upper extremities.
  • Dye injection studies to determine flap size and vascular support.

Main Results:

  • A cutaneous branch of the AIA, the dorsal septocutaneous branch (DSCB), supplies the distal dorsal forearm.

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  • Average DSCB origin diameter: 1.1 mm. Mean pedicle length: 3.1 cm (extendable to 12.4 cm).
  • Supported skin paddle size ranged from 5x9 cm to 8x15 cm.
  • Conclusions:

    • A new flap based on the AIA's DSCB is feasible for dorsal hand reconstruction.
    • The flap can be adapted into various configurations (island, free, composite).
    • This anatomical study provides a basis for clinical application in reconstructive surgery.