Pedicled SCIA and SIEA Mega Groin Flap-A Staged Reconstructive Approach for Large Forearm Defects
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- Lai Yu-Ming
- Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital
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- Eong Jonathan T.W. Au
- Lee Kong Chian School of Medicine, Nanyang Technological University
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- Tan Bien-Keem
- Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital
抄録
<p>Objective: The pedicled combined superficial circumflex iliac artery and superficial inferior epigastric artery flap has a large vascular territory ideal for coverage of crush-degloving injuries of the upper extremity. We describe our technique of creating a bipedicled flap through a staged inset, first at the wrist and subsequently progressing up the forearm. This process allows primary thinning of the entire flap while facilitating a safe transfer of the flap.</p><p>Methods: Three patients with crush-degloving injury of the forearm associated with open fractures of the radius and ulnar bones had their defects reconstructed using the aforementioned flap. Patient 3 also had avulsion of the ulnar artery and crush injury of the median and ulnar nerves. Patients 1 and 2 underwent flap delay and training for 1 week prior to inset. Patient 3 did not undergo delay due to the broad-based nature of the flap. The maximal flap size was 25 × 15 cm. The flap was raised thinly until the sufficient length was obtained for the first-stage inset. Over 2 weeks, further elevation and staged inset were performed to maintain uniform thinness and thereby maximize coverage.</p><p>Results: Complete flap division was accomplished in 3 weeks. All flaps survived with no marginal flap necrosis. Donor sites were closed directly (n = 2) or skin grafted (n = 1).</p><p>Conclusions: Staged insetting created a bipedicled construct, which allowed primary thinning of the base and bridging portion, thereby allowing maximal use of the entire flap. Maximising the flap was possible because our technique maintained a bipedicled circulation throughout the entire inset process.</p>
収録刊行物
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- Journal of Plastic and Reconstructive Surgery
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Journal of Plastic and Reconstructive Surgery 3 (2), 64-70, 2024-04-27
一般社団法人 日本形成外科学会
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詳細情報 詳細情報について
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- CRID
- 1390299981561984256
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- ISSN
- 2436259X
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
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- 抄録ライセンスフラグ
- 使用不可