Versatility and Dependability of Posterior Interosseous Artery Flap in Hand Soft Tissue Defect Reconstruction
- 1. Professor, Department of Plastic Surgery, Patna Medical College and Hospital, Patna, Bihar, India
- 2. M.Ch Plastic Surgery, Department of Plastic Surgery, Patna Medical College and Hospital, Patna, Bihar, India
Description
Objectives: The study aimed to assess the efficacy of the distally based dorsal forearm fasciocutaneous flap utilizing the posterior interosseous artery in soft tissue reconstruction for hand defects, to evaluate its functional and aesthetic outcomes. Methods: A prospective study spanning for over a year was conduct at Patna Medical College and Hospital in Patna, Bihar, India on 30 patients with soft tissue hand defects, employing a comprehensive approach to assess factors such as age, occupation, hand dominance, smoking habits, systemic ailments, and injury mechanisms. The surgical intervention involved utilizing the distally based dorsal forearm fasciocutaneous flap based on the posterior interosseous artery (PIA), with preoperative preparation, markings, and operative techniques meticulously outlined. Results: The study, comprising 30 individuals with an average age of 31.28 years, predominantly included males (80%). Vehicle accidents were the most common cause of hand injuries (27%), with the dorsum of the left hand being the primary injury site (40%). Scar assessment revealed 80% of cases had a ‘good’ outcome, while the mean DASH score was 35.14, indicating satisfactory functional results. Donor site problems occurred in 13% of cases, and post-surgery complications included a 7% incidence of distal flap necrosis and 7% experiencing venous congestion, with an average hospital stay of 7.1 days. Conclusion: The study demonstrates the efficacy of the distally based dorsal forearm fasciocutaneous flap based on the PIA for soft tissue hand reconstruction, with favorable scar outcomes and functional results. Recommendation: The study recommends further exploration with larger cohorts and comparative analyses to enhance the generalizability of findings in soft tissue hand reconstruction. Additionally, ongoing research should focus on refining techniques to minimize donor site problems and post-surgery complications.
Abstract (English)
Objectives: The study aimed to assess the efficacy of the distally based dorsal forearm fasciocutaneous flap utilizing the posterior interosseous artery in soft tissue reconstruction for hand defects, to evaluate its functional and aesthetic outcomes. Methods: A prospective study spanning for over a year was conduct at Patna Medical College and Hospital in Patna, Bihar, India on 30 patients with soft tissue hand defects, employing a comprehensive approach to assess factors such as age, occupation, hand dominance, smoking habits, systemic ailments, and injury mechanisms. The surgical intervention involved utilizing the distally based dorsal forearm fasciocutaneous flap based on the posterior interosseous artery (PIA), with preoperative preparation, markings, and operative techniques meticulously outlined. Results: The study, comprising 30 individuals with an average age of 31.28 years, predominantly included males (80%). Vehicle accidents were the most common cause of hand injuries (27%), with the dorsum of the left hand being the primary injury site (40%). Scar assessment revealed 80% of cases had a ‘good’ outcome, while the mean DASH score was 35.14, indicating satisfactory functional results. Donor site problems occurred in 13% of cases, and post-surgery complications included a 7% incidence of distal flap necrosis and 7% experiencing venous congestion, with an average hospital stay of 7.1 days. Conclusion: The study demonstrates the efficacy of the distally based dorsal forearm fasciocutaneous flap based on the PIA for soft tissue hand reconstruction, with favorable scar outcomes and functional results. Recommendation: The study recommends further exploration with larger cohorts and comparative analyses to enhance the generalizability of findings in soft tissue hand reconstruction. Additionally, ongoing research should focus on refining techniques to minimize donor site problems and post-surgery complications.
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IJPCR,Vol15,Issue12,Article320.pdf
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Additional details
Dates
- Accepted
-
2023-12-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue12,Article320.pdf
- Development Status
- Active
References
- 1. Saha S.: Minimally invasive successful reconstruction of a severely traumatized upper extremity using plateletrich plasma and tissue scaffold: A case report. Surg. J. (NY), 2022;8: 28-33. 2. De S.D. and Sebastin S.J.: Considerations in flap selection for soft tissue defects of the hand. Clin. Plast. Surg., 2019; 46: 393-406. 3. Ghareeb F., Megahed M., El Kashty S., Labeb A. and Abd El Kader H.: Functional and cosmetic outcomes of posterior interosseous artery flap in reconstructing hand defects. Menoufia Med. J., 2018;31: 1375-9. 4. De Francesco F., Busato A., Mannucci S., Zingaretti N., Cottone G., Amendola F., et al.: Artificial dermal substitutes for tissue regeneration: comparison of the clinical outcomes and histological findings of two templates. J. Int. Med. Res., 2020;48: 300-9. 5. Adani R., Tang J.B. and Elliot D.: Soft and tissue repair of the hand and digital reconstruction. J. Hand Surg. Eur., 2022; 47: 89-97. 6. Zancolli E.A. and Angrigiani C.: Colgajo dorsal de antebrazo (en isla). Rev. Asoc. Argent Ortop. Traumatol., 1986;1: 161-8. 7. Penteado C.V., Masquelet A.C. and Chevrel J.P.: The anatomic basis of the fasciocutaneous flap of the posterior interosseous artery. Surg. Radiol. Anat., 1986;8: 209-15. 8. Safeek R.H., O'Toole A., Furtado W.R., Wilhemi B.J. and Choo J.H.: Isolated ulnar artery injury: Indications for and timing of operative intervention. Eplasty, 2022;22: 37-45. 9. Kelada M.N., Salem R.R., Eltohfa Y.A., Ghozlan N.A. and Kholosy H.M.: "Posterior interosseus artery flap for hand reconstruction: Anatomical basis and clinical application". BMC MusculoskeletDisord, 2022;23: 662-9. 10. Ren J., Lu L. and Gao F.: The use of the posterior interosseous artery flap and anterolateral thigh flap for posttraumatic soft tissue reconstruction of the hand. Medicine (Baltimore), 2021;100: 265-72. 11. Zancolli E. and Angrigiani C.: Posterior interosseous island forearm flap. J. Hand Surg. Eur., 1988;13: 130-5. 12. Sönmez E., Aksam E., Durgun M. and Karaaslan O.: Venous super-drained posterior interosseous artery flap for dorsal hand defects. Microsurgery, 2018;38: 876-81. 13. Costa H., Comba S., Martins A., Rodrigues J., Reis J. and Amarante J.: Further experience with the posterior interosseous flap. Br. J. Plast. Surg., 1991;44: 449-55. 14. Dap F., Dautel G., Voche P., Thomas C. and Merle M.: The posterior interosseous flap in primary repair of hand injuries. A review of 23 cases. J. Hand Surg. Br., 1993;18: 437- 45. 15. Brunelli F., Valenti P., Dumontier C., Panciera P. and Gilbert A.: The posterior interosseous reverse flap: Experience with 113 flaps. Ann. Plast. Surg., 2001;47: 25-30. 16. Landi A., Luchetti R., Soragni O., De Santis G. and Sacchetti G.L.: The distally based posterior interosseous island flap for the coverage of skin loss of the hand. Ann. Plast. Surg., 1991;27: 527-36. 17. Chen H.C., Cheng M.H., Schneeberger A.G., Cheng T.J., Wei F.C. and Tang Y.B.: Posterior interosseous flap and its variations for coverage of hand wounds. J. Trauma, 1998;45: 570- 4. 18. Shashaa M.N., Swed S., Albahhah T. and Alloush H.: Newly repairing technique of deformed hand by a posterior interosseous flap in an infant: A case report. Int. J. Surg. Case Rep., 2022;95: 107-15. 19. Prasetyono T.O.H. and Menna C.: Cutaneous perforators and their clinical implications on intrinsic hand flaps: A systematic review. Plast. Reconstr. Surg. Glob. Open, 2022; 10:41-54.