Versatility of the reverse dorsoulnar fasciocutaneous flap in coverage of hand defects: clinical experience with 36 cases.
OBJECTIVE
Local flap reconstruction is often required for soft tissue defects of the hand. The optimal reconstruction method should provide thin, supple, well-vascularized tissue with minimal donor-site morbidity. Short operating time and a sizable pedicle for microsurgical anastomosis are helpful. In this study, outcomes of hand defects after reconstruction with a reverse dorsoulnar flap were retrospectively analyzed.


METHODS
Between 2001 and 2008, 36 patients were evaluated (28 men, 8 women). Twenty-seven pedicle flaps and 9 free flaps were used. Nineteen patients had flexion contractures in their palms and fingers after burn injuries, 14 patients had traumatic soft tissue loss, and 3 patients had defects after tumor exicision. In 26 cases the defects were on the palm site, and in 10 cases the defects were on the dorsum of the hand. Mean follow-up was 12 months.


RESULTS
The success rate was 100%, with satisfactory cosmetic results. Functional recovery of the hands showed good results as well as acceptable donor healing without complication.


CONCLUSIONS
The dorsoulnar flap as either pedicle or free flap provides good and reliable skin cover for substantial soft tissue defects on the palm, dorsum of the hand, and the fingers.
Uygur
Fatih
F
Department of Plastic and Reconstructive Surgery and Burn Unit, Gülhane Military Medical Academy and Medical Faculty, Haydarpasha Training Hospital, Istanbul, Turkey. fatihuygur@hotmail.com
Uygur
Müjde
M
Ulkür
Ersin
E
Sever
Celalettin
C
D000328:Adult; D002056:Burns / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D015331:Cohort Studies; D003286:Contracture / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006227:Hand Deformities, Acquired / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006230:Hand Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult