title: Defining the Indications of Pedicled Groin and Abdominal Flaps in Hand Reconstruction in the Current Microsurgery Era.
abstract: Three decades ago, pedicled flaps from the groin and abdomen were the workhorses in hand and forearm reconstruction. These pedicled flaps have several disadvantages including patient discomfort, stiffness, the need for flap division, and the inability to elevate the hand after acute trauma. Hence it is not surprising that free flap reconstruction has become the method of choice in coverage of complex hand and forearm defects. Despite this, pedicled flaps may still be indicated in the current era of microsurgery. Based on a review of the literature and the author's experience, the current review defines these indications as follows: complex defects in children aged less than 2 years; coverage of digital stump defects in preparation for toe-to-hand transfer; high-voltage electric burns with the hand surviving on collateral blood supply; salvage of the thumb ray in high-voltage electric burns with concurrent thrombosis of the radial artery; mutilating hand injuries; length preservation of multiple digital amputations in manual workers; and multiple defects within the digits, hand, or forearm. These indications are discussed along with clinical examples.
authors.affiliation: Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia. Electronic address: moqattan@hotmail.com.
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Al-Qattan
authors.affiliation: Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Al-Qattan
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D005543:Forearm Injuries / Q000601:surgery*; D006119:Groin / Q000601:surgery; D006225:Hand / Q000601:surgery; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008866:Microsurgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*
keywords: Pedicle flap; groin flap; hand reconstruction