Versatility of Free Cutaneous Flaps for Upper Extremity Soft Tissue Reconstruction

Howard D. Wang; Jose C. Alonso-Escalante; Brian H. Cho; Ramon A. DeJesus

doi:10.1055/s-0037-1603918

Journal of Hand and Microsurgery, Table of Contents

J Hand Microsurg 2017; 09(02): 058-066
DOI: 10.1055/s-0037-1603918

Review Article

Thieme Medical and Scientific Publishers Private Ltd.

Versatility of Free Cutaneous Flaps for Upper Extremity Soft Tissue Reconstruction

Howard D. Wang

¹Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland, United States

,

Jose C. Alonso-Escalante

¹Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland, United States

,

Brian H. Cho

¹Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland, United States

,

Ramon A. DeJesus

¹Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland, United States

²Division of Plastic, Maxillofacial, and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, United States

³Department of Plastic and Reconstructive Surgery, National Military Center, San Diego, California, United States

› Author Affiliations

Abstract

The goals of upper extremity soft tissue reconstruction should go well beyond providing coverage and restoring function. As the field of reconstructive microsurgery has evolved, free cutaneous flaps (FCFs) are gaining wider application. The advantages of FCF include minimizing donor-site morbidity by preserving the muscle and fascia, improving versatility of flap design, and superior aesthetic results. This review highlights the application of anterolateral thigh, superficial circumflex iliac artery, deep inferior epigastric perforator, superficial inferior epigastric artery, and flow-through flaps for reconstruction of upper extremity defects. These flaps share several qualities in common: well-concealed donor sites, preservation of major arteries responsible of providing inflow to distal extremity, and potential for a two-team approach (donor and recipient sites). While the choice of flaps should be decided based on individual patient and defect characteristics, FCF should be considered as excellent options to achieve the goals of upper extremity reconstruction.

Keywords

free cutaneous flaps - upper extremity reconstruction - anterolateral thigh flap - superficial circumflex iliac artery flap - deep inferior epigastric perforator flap - superficial inferior epigastric artery flap

Full Text

References

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