Alternative Flap Options for Upper Extremity Reconstruction - 28/03/24

Doi : 10.1016/j.hcl.2023.08.010

Yanis Berkane, MD, MSc ^a,^b,^c,^{^{1
Contributed equally.}}, Riccardo Giorgino, MD ^d,^e,^f,^{^{1
Contributed equally.}}, Zhi Yang Ng, MBChB, MRCS, PhD ^g, Ruben Dukan, MD, MSc ^h, Alexandre G. Lellouch, MD, PhD ^b,^i,^j,^⁎
^a Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France
^b Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
^c UMR U1236-MICMAC, Immunology and Cell Therapy Lab, Rennes University Hospital, 2 Rue Henri Le Guillou, 35000 Rennes, France
^d Residency Program in Orthopaedics and Traumatology, University of Milan, Via Cristina Belgioioso, 173, 20161 Milan, Italy
^e IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso, 173, 20161 Milan, Italy
^f Plastic Surgery Research Laboratory, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
^g Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 9DU, UK
^h Department of Hand, Upper Limb & Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), 20 Rue Leblanc, Paris, France
ⁱ Department of Plastic, Reconstructive & Aesthetic Surgery, Georges-Pompidou European Hospital (HEGP), University of Paris, 20 Rue Leblanc, Paris, France
^j Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, F-75006, Paris, France

^∗Corresponding author. Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114.Vascularized Composite Allotransplantation LaboratoryMassachusetts General HospitalHarvard Medical School50 Blossom StreetBostonMA02114

Résumé

For major upper limb defects, a wide range of established pedicled and free flap options can be used. These include the latissimus dorsi/thoracodorsal artery perforator, lateral arm, posterior interosseous artery, rectus abdominis, gracilis, and anterolateral thigh flaps. Technical proficiency is essential, and favorable success rates in terms of functional and esthetic outcomes can be achieved. Herein, alternative flap options (both pedicled and free) are introduced and discussed through a few illustrative case examples.

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Keywords : Upper extremity, Flap reconstruction, DIEP flap, SCIP flap, Microsurgical reconstruction

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Introduction

Alternative flap options

Case 1. Free Bipedicled DIEP Flap

Case 2. Pedicled Latissimus Dorsi Flap

Case 3. Pedicled Brachioradialis Muscle Flap

Case 4. Free Superficial Circumflex Iliac Artery Perforator Flap

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Vol 40 - N° 2

P. 291-299 - mai 2024 Retour au numéro

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Alternative Flap Options for Upper Extremity Reconstruction - 28/03/24

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