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European Journal of Plastic Surgery

, Volume 14, Issue 6, pp 288–293 | Cite as

The pros and cons of distant pedicled flaps for upper extremity trauma reconstruction in the era of microvascular surgery

  • P. Graft
  • H. U. Steinau
  • G. Ingianni
  • E. Biemer
Originals

Summary

Nineteen distant pedicled flaps, performed during 1989 for posttraumatic upper extremity soft tissue defect cover were reviewed. The pros and cons of distant pedicled flaps were examined with respect to the alternative treatment; namely, free microvascular tissue transfer. The main points considered were the traumatic defect, the donor site and particular problems of each patient. The conclusion was that pedicled flaps are useful in this type of reconstruction in spite of the availability of microvascular techniques.

Key words

Hand trauma Distant pedicled flaps Free tissue transfer 

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References

  1. 1.
    Beasley RW (1967) Principles and techniques of resurfacing operations for hand surgery. Surg Clin North Am 47:389–413Google Scholar
  2. 2.
    Biemer E (1984) Reconstruction of the hand with two-toe block transfer and neurovascular flaps from the foot. In: Symposium on clinical frontiers in reconstructive microsurgery. Mosby, St Louis, vol 24, pp 227–238Google Scholar
  3. 3.
    Browse NL, Burnand KG, Thomas ML (1988) Diseases of the veins. In: Arnold E (ed) Pathology, diagnosis and treatment. London Baltimore Melbourne Auckland, Edition 1, p 605Google Scholar
  4. 4.
    Buck-Gramcko D (1968) Deckung von Hautdefekten an der Hand, 1. Allgemeiner Teil. Chir Praxis 12:85–94Google Scholar
  5. 5.
    Buck-Gramcko D (1968) Deckung von Hautdefekten an der Hand, 2. Spezieller Teil. Chir Praxis 12:263–273Google Scholar
  6. 6.
    Buck-Gramcko D, Epping W (1974) Der Leistenlappen in der Handchirurgie. Handchirurgie 6:55–63Google Scholar
  7. 7.
    Chow JA, Bilos ZJ, Hui P, Hall RF, Seyfer AE, Smith AC (1986) The groin flap in reparative surgery of the hand. Plast Reconstr Surg 77:421–425Google Scholar
  8. 8.
    Chuang DCC, Colony LH, Chen HC, Wei FC (1989) Groin flap design and versatility. Plast Reconstr Surg 84:100–107Google Scholar
  9. 9.
    Cockett FB, Thomas ML (1965) The iliac compression syndrome. Br J Surg 52:816–821Google Scholar
  10. 10.
    Colen SR, Shaw WW, McCarthy JG (1986) Review of the morbidity of 300 free flap donor sites. Plast Reconstr Surg 77:948–953Google Scholar
  11. 11.
    Colson P (1967) Utilisation des lambeaux dégraissës (lambeauxgreffes) en chirurgié répratrice de la main. Ann Chir Plast 12:298–302Google Scholar
  12. 12.
    Katsaros J, Tan E, Zoltie N (1989) Free flap cover of acute hand injuries. Injury 20:96–97Google Scholar
  13. 13.
    Kelleher JC, Sullivan JG, Baibaek G, Dean RK (1970) Use of a tailored abdominal pedicle flap for surgical reconstruction of the hand. J Bone Joint Surg [Am] 52:1552–1562Google Scholar
  14. 14.
    Knutson GH (1977) The groin flap: a new technique to repair traumatic tissue defects. Can Med Assoc J 116:623–625Google Scholar
  15. 15.
    Krylov VS, Milanov NO, Borovikov AM, Trofimov EI, Shiriaev AA (1985) Functional reconstruction of both hands by free tissue transfer of combined second and third toes from both feet. Plast Reconstr Surg 75:584–587Google Scholar
  16. 16.
    Lister GD, McGregor IA, Jackson IT (1972) The groin flap in hand injuries. Injury 4:229–239Google Scholar
  17. 17.
    Mathes SJ, Alpert BS, Chang N (1982) Use of the muscle flap in chronic osteomyelitis: experimental and clinical correlation. Plast Reconstr Surg 69:815–828Google Scholar
  18. 18.
    May JW, Bartlett SP (1981) Staged groin flap in reconstruction of pediatric hand. Hand Surg 6:163–171Google Scholar
  19. 19.
    McCash B (1956) Cross-arm bridge flaps in the repair of flexion contractures of the fingers. Br J Plast Surg 9:25–32Google Scholar
  20. 20.
    McDonald LL, Webster JP (1946) Early covering of extensive traumatic deformities of the hand and foot. Plast Reconstr Surg 1:49–57Google Scholar
  21. 21.
    McGregor IA, Jackson IT (1972) The groin flap. Br J Plast Surg 25:3–16Google Scholar
  22. 22.
    McGregor IA (1979) Flap reconstruction in hand surgery: the evolution of presently used methods. Hand Surg 4:1–10Google Scholar
  23. 23.
    McGregor IA (1986) Discussion to the article: (Chow JA, Bilos ZJ, Hui P, Hall RF, Seyfer AE, Smith AC) The groin flap in reparative surgery of the hand. Plast Reconstr Surg 77:426Google Scholar
  24. 24.
    McGregor JC (1984) The completely degloved hand. Chir Plastica 7:267–271Google Scholar
  25. 25.
    Rees MJW, Mehrotra ON (1987) Economical use of the groin flap: then and now. Br J Plast Surg 40:647–650Google Scholar
  26. 26.
    Smith PJ, Foley B, McGregor IA, Jackson IT (1972) The anatomical basis of the groin flap. Plast Reconstr Surg 49:41–47Google Scholar
  27. 27.
    Smith PJ (1982) The Y-shaped hypogastric groin flap. Hand 14:263–270Google Scholar
  28. 28.
    Steinau HU, Biemer E, Feller A-M, Hörl HW (1988) Primär-versorgung und sekundäre Wiederherstellungschirurgie der schweren kombinierten Handverletzung. Chirurg 59:740–748Google Scholar
  29. 29.
    Steinau HU, Feller A-M, Biemer E (1989) Mehrblättrige freie Transplantate zum Verschluß multifokaler Gewebedefekte. Handchir Mikrochir Plast Chir 21:23–25Google Scholar
  30. 30.
    Teich-Alasia S, Barberis ML (1972) The value of the “cross arm” flap in reconstructive surgery of the hand. Chir Plastica 1:134–144Google Scholar
  31. 31.
    Vollmar J (1971) Steal syndrome. Munch Med Wochenschr 113:501–506Google Scholar
  32. 32.
    Wood MB, Irons GB (1983) Upper extremity free skin flap transfer: results and utility as compared with conventional distant pedicle skin flaps. Ann Plast Surg 11:523–526Google Scholar
  33. 33.
    Wray RC, Wise DM, Young VL, Weeks PM (1982) The groin flap in severe hand injuries. Ann Plast Surg 9:459–462Google Scholar
  34. 34.
    Yu ZJ (1987) Combined transplantations of free tissues. Plast Reconstr Surg 79:222–233Google Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • P. Graft
    • 1
  • H. U. Steinau
    • 2
  • G. Ingianni
    • 3
  • E. Biemer
    • 1
  1. 1.Department of Plastic and Reconstructive SurgeryTechnical University HospitalMünchen 80Germany
  2. 2.Department of Plastic Surgery, Burn UnitBG-University HospitalBochum 1Germany
  3. 3.Department of Plastic and Reconstructive SurgeryWuppertal 1Germany

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