title: The pedicled inferior paraumbilical perforator (I-PUP) flap for a volar wrist defect: a reconstructive solution across the ages.
abstract: Full-thickness soft-tissue defects overlying vital forearm or wrist structures frequently result from acute trauma or tumor ablation. These defects present reconstructive challenges, due to the thin pliable skin to be replaced and the non-graftable bed beneath. The authors discuss a case of a renal-transplant patient with a volar wrist SCC, in whom local vascular anatomy deemed microvascular free tissue transfer inappropriate. The authors present a successful novel reconstructive solution; the pedicled inferior paraumbilical perforator flap (I-PUP), a two-staged procedure that incorporates principles of distant flaps--which pre-date microsurgery--combined with techniques and lessons learned in the era of perforator flap surgery.
authors.affiliation: Plastic and Reconstructive Surgery Unit, Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia; AORTEC Unit, Faculty of Health Science, Australian Catholic University, O'Brien Institute, Fitzroy, Victoria 3065, Australia. Electronic address: lipi.shukla@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Shukla
authors.forename: G I
authors.initials: GI
authors.lastname: Taylor
authors.forename: R
authors.initials: R
authors.lastname: Shayan
mesh_terms: D034861:Abdominal Wall; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D019651:Plastic Surgery Procedures; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation; D014953:Wrist / Q000473:pathology / Q000601:surgery*
keywords: Flap; Forearm; Paraumbilical; Perforator; Reconstruction; Wrist