The fate of the dorsal metacarpal arterial system following thermal injury to the dorsal hand: A Doppler sonographic study.
Hands are involved in over 70% of all serious burns. This study comprised 80 hands in 41 patients with burns of the dorsum of the hand. Eighty percent of the hands in our study had deep partial-thickness and full-thickness burns that had to be grafted. This study was performed to evaluate the patency of the dorsal metacarpal artery (DMCA) system in burn-injured hands. Sixteen hands healed spontaneously; 62 had to be excised and grafted. Doppler mapping of the dorsum of the hand was completed using an 8-MHz probe. Patent vessels were found in a pattern similar to that of a normal population in spontaneously healed and grafted partial-thickness burns. The incidence of dorsal arteries decreased from 100% for the first DMCA to 80% for the DMCA in the fourth web space. In full-thickness burns the correlation of burned hands to normal volunteers was only 80%. It can be concluded from the data that the DMCA system is not damaged by deep partial-thickness burns that are excised and grafted. The DMCA system is still intact in 80% of patients with full-thickness burns. The potential for elevating a DMCA flap is therefore preserved after burn excision and grafting. Preoperative Doppler examinations are recommended before planning the flaps.
Germann
G
G
Department of Plastic and Hand Surgery, Burn Center, BG, Trauma Center, Plastic and Hand Surgery, The University of Heidelberg, Ludwigshafen, Germany.
Funk
H
H
Bickert
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging; D002056:Burns / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006230:Hand Injuries / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000098:blood supply*; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D013524:Surgical Flaps / Q000098:blood supply; D018608:Ultrasonography, Doppler