title: [Reconstruction of through and through gunshot injuries of the hand with a double skin paddle reverse-flow forearm radial flap. Two case reports].
abstract: The authors report two cases of gunshot wounds to the hand treated with a double skin paddle reverse-flow forearm flap. The two cases, male and female, were due to a self-inflicted rifle injury. The wounds were severe and extensive with full-thickness palmar and dorsal skin, tendon, muscle, bone, vessel and nerve losses. Treatment was performed in a single stage with skeletal stabilization, bone grafting and nerve and tendon reconstruction. The double palmar and dorsal skin defect was reconstructed with a double skin paddle reverse-flow forearm flap which was routed through the hand wound. The forearm flap is the sole way, free flaps excepted, to achieve reliable hand dorsal and palmar coverage in a single stage. In addition, this technique simplifies the reconstruction by using a local flap and allows better management for healing and rehabilitation as compared to a multiple flap procedure.
authors.affiliation: Service de chirurgie de la main et de chirurgie plastique et réparatrice des membres, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 05, France. cecphil@voila.fr
authors.forename: C
authors.initials: C
authors.lastname: Philandrianos
authors.forename: D
authors.initials: D
authors.lastname: Guinard
authors.forename: R
authors.initials: R
authors.lastname: Legré
mesh_terms: D000328:Adult; D005260:Female; D005542:Forearm / Q000601:surgery; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D013406:Suicide, Attempted; D013524:Surgical Flaps / Q000098:blood supply*; D014948:Wounds, Gunshot / Q000473:pathology / Q000601:surgery*