title: Reconstruction of extensive upper extremity defects using pre-expanded oblique perforator-based paraumbilical flaps.
abstract: The pedicled paraumbilical flap is a reliable tissue transfer for hand and forearm reconstruction. However, its size, pedicle length and/or thickness limit its application in resurfacing of extensive defects of the upper limb. To conquer those limitations, this flap was pre-expanded for 10-24 weeks prior to transfer in 25 patients and used as a pedicle flap to cover upper extremity defects. Extensive defects of upper limb were reconstructed by the pre-expanded paraumbilical flaps. The flaps ranged in size from 10 cm × 8 cm to 30 cm × 14 cm. The donor sites were closed directly in all cases. All flaps survived, but two had partial flap necrosis due to venous congestion or infection. With pre-transfer expansion, a large, well-perfused abdominal pedicle flap can be raised and transferred based on the paraumbilical perforators. This pre-expanded flap might be useful in the patients who have the extensive upper limb defects and sufficient time to allow tissue expansion.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Peking Union Medical College, Ba-Da-Chu Road, 33(#), Beijing 100144, China.
authors.forename: Mengqing
authors.initials: M
authors.lastname: Zang
authors.forename: Shan
authors.initials: S
authors.lastname: Zhu
authors.forename: Bin
authors.initials: B
authors.lastname: Song
authors.forename: Ji
authors.initials: J
authors.lastname: Jin
authors.forename: Donghong
authors.initials: D
authors.lastname: Liu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
authors.forename: Yuanbo
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000601:surgery*; D002056:Burns / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016038:Skin Transplantation / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000379:methods*; D060053:Transplant Donor Site; D055815:Young Adult