The combined use of a pedicled superficial inferior epigastric artery flap and a groin flap for reconstruction of a dorsal and volar hand blast injury.
A hand blast injury case causing a large through-and-through composite tissue loss is presented. This injury resulted in a dorsal and a palmar hand defect with segmental bone loss. Soft tissue coverage of both dorsal and palmar wounds was achieved by two separate pedicle flaps with pedicles closely arising from the femoral artery: a superficial inferior epigastric artery (SIEA) flap and a groin flap. Simultaneously, a large iliac corticocancellous bone graft was harvested from the same incision to be used for the wrist fusion procedure. This approach uses two separate pedicled flaps with robust independent blood supply to cover simultaneously a dorsal and a volar hand wound. A large through-and-through hand defect can be reconstructed readily with this approach, and it is associated with much less perioperative morbidity compared to free composite tissue transfer options. The dissection of both the groin flap and the SIEA flap is straightforward and can be easily performed by a single surgeon. The combined use of these two flaps allows stable coverage of sizable dorsal and palmar wounds of the hand.
Choi
Joon Y
JY
Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System, 2130 Taubman Center, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0340, USA. joonchoi@umich.edu
Chung
Kevin C
KC
Burns. 2006 Aug;32(5):660-1
16784817
J Hand Surg Br. 1997 Oct;22(5):620-2
9752918
J Hand Surg Am. 2002 May;27(3):525-33
12015730
Br J Plast Surg. 1992 Feb-Mar;45(2):86-8
1562852
Ann Plast Surg. 1989 Dec;23(6):543-6
2624397
Plast Reconstr Surg. 1975 Sep;56(3):243-53
1098069
Hand. 1982 Oct;14(3):263-70
6218034
Ann Acad Med Singap. 1979 Oct;8(4):404-12
539805
Plast Reconstr Surg. 1988 Apr;81(4):534-44
3347663
J Hand Surg Am. 2001 Sep;26(5):956-61
11561252
Br J Plast Surg. 1981 Jul;34(3):349-52
7272578
Br J Plast Surg. 2004 Sep;57(6):515-9
15308397