title: Upper extremity salvage with a flow-through free flap.
abstract: In complex extremity injuries, which include composite tissue lost with devascularization caused by segmental vascular damage, simultaneous coverage of the defects with revascularizations should be required. One-stage reconstruction of both soft tissue coverage and vascular damage can be performed by a flow-through-type free flap. In this series, 5 patients between 13 and 36 years of age with wide composite tissue defects in the cubital region and segmental defects in brachial arteries were operated at our clinic between 1996 and 2003. With the aim of reconstructing the wide tissue defects in the cubital region as well as that of the brachial artery, a radial arterial flow-through flap was applied. The radial artery of the flow-through flap was anastomosed to the proximal ends of the brachial and ulnar arteries in an end-to-end fashion. In 4 of the patients, the radial arterial flow-through flap was prepared from the distal aspect of the wounded forearm and in 1 patient from the contralateral forearm. In the postoperative period, no complications related to the anastomosis were encountered in the flap with all anastomoses found to be patent, and distal circulation was restored. The radial arterial flow-through flap is very useful in the clinical field of major trauma of the cubital region with brachial artery damage with numerous advantages that include the opportunity to work in one single surgical area, shorter dissection times resulting from simple and fixed anatomy, perfect color and tissue adaptation, and the suitability of the vessel caliber and length.
authors.affiliation: Cukurova University, Medical Faculty, Plastic, Reconstructive and Aesthetic Surgery Department, Adana, Turkey. ekesiktas@yahoo.com
authors.forename: Erol
authors.initials: E
authors.lastname: Kesiktas
authors.forename: Metin
authors.initials: M
authors.lastname: Yavuz
authors.forename: Cemil
authors.initials: C
authors.lastname: Dalay
authors.forename: Nüket
authors.initials: N
authors.lastname: Kesiktas
authors.forename: Gökhan
authors.initials: G
authors.lastname: Ozerdem
authors.forename: Sabri
authors.initials: S
authors.lastname: Acartürk
mesh_terms: D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000601:surgery*; D005260:Female; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D016879:Salvage Therapy / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D015599:Trauma Severity Indices; D034941:Upper Extremity