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Soft tissue reconstruction with small free flaps in hand and finger defects

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

With the technological and technical improvements in microsurgery, the defect reconstruction with free flaps has increased in hand surgery. In this study, we aimed to evaluate the results of free posterior interosseous perforator (PIAP) flap, free superficial palmar branch of the radial artery (SUPBRA) flap and hypothenar free perforator flap in hand and finger defects.

Methods

A total of 58 patients who were operated between 2017 and 2021 were included in the study. Hand defects of patients occurred due to industrial accidents and reconstructed by using free SUPBRA, free PIAP and hypothenar free perforator flaps were included into the study. Demographics of patients, characteristics of the flaps and complications were evaluated retrospectively.

Results

Twenty eight free SUPBRA flap, 12 hypothenar free perforator flap and 18 free PIAP flap surgeries were performed. Static and dynamic two-point discrimination tests were evaluated and acceptable results were obtained. Donor site scar was compared with the non-operated side by using visual analogue scale (VAS). The median VAS values were calculated as 8 for three different flaps. Total necrosis developed in 3 patients. Other complications are hematoma, partial necrosis and wound dehiscence in the donor area.

Conclusion

We obtained good aesthetic and functional results by using free small flaps in hand and finger defects. As the experience of perforator-to-perforator anastomosis increases, the use of these flaps in the reconstruction of hand defects is increasing.

Level of evidence: Level III, Therapeutic.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Plastic, Reconstructive and Aesthetic Surgery, Konur Hospital, Bursa, Turkey

    Alper Aksoy

  2. Department of Plastic, Reconstructive and Aesthetic Surgery, Turgutlu State Hospital, Manisa, Turkey

    Yavuz Tuluy

  3. Department of Plastic, Reconstructive and Aesthetic Surgery, İzmir Kavram Vocational School, İzmir, Turkey

    Emin Sır

  4. Department of Plastic, Reconstructive and Aesthetic Surgery, Acıbadem Taksim Hospital, Istanbul, Turkey

    M Baver Acaban

Authors
  1. Alper Aksoy
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  2. Yavuz Tuluy
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  3. Emin Sır
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Corresponding author

Correspondence to Yavuz Tuluy.

Ethics declarations

Ethical approval

The ethical approval is exempted due to the retrospective nature of the study and according to the local law. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

All the patients have provided written informed consent for the surgery, their data and images.

Conflict of interest

Alper Aksoy, Yavuz Tuluy, Emin Sır, and M Baver Acaban declare no conflict of interest.

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Aksoy, A., Tuluy, Y., Sır, E. et al. Soft tissue reconstruction with small free flaps in hand and finger defects. Eur J Plast Surg 46, 1283–1291 (2023). https://doi.org/10.1007/s00238-023-02128-3

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  • DOI: https://doi.org/10.1007/s00238-023-02128-3

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