Reverse flow flap use in upper extremity burn contractures.
Upper extremity contractures still happen and constitute one of the most trying challenges in burn patients. This series comprised of 4 radial forearm flaps, 14 dorsoulnar artery flaps, and 4 medial arm flaps, all of which were used in a reverse pattern for upper extremity postburn contractures. The reverse flow radial forearm flap (RRFF) was chosen for reconstruction of extensive palmar contractures after burn. The reverse flow dorsoulnar flap (RDUF) was used particularly for reconstruction of the hypothenar aspect of the hand which requires moderate size tissue transfer. The reverse medial arm flap (RMAF) was used for elbow contractures after burn. In the first RMAF, venous congestion occurred and was finaly resolved with minimal flap loss, which was managed with STSG later. In the following 3 cases the flap was supercharged with anastomosis of the brachial vein into the antebrachial vein. Both RRFF and RDUF may provide a smooth and efficient solution. However, RMAF has a significant venous problem, which may result in flap loss, therefore, this flap should not be considered as a first option in the elbow area.
Uygur
Fatih
F
Department of Plastic and Reconstructive Surgery and Burn Unit, Gülhane Military Medical Academy and Medical Faculty, Haydarpaşa Training Hospital, Istanbul, Turkey. fatihuygur@hotmail.com
Sever
Celalettin
C
Evinç
Rahmi
R
Ulkür
Ersin
E
Duman
Haluk
H
D000328:Adult; D001132:Arm / Q000601:surgery; D002056:Burns / Q000150:complications / Q000534:rehabilitation*; D002921:Cicatrix / Q000601:surgery; D003286:Contracture / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D004550:Elbow / Q000098:blood supply / Q000601:surgery*; D005542:Forearm / Q000601:surgery; D006085:Graft Survival; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries