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Subject Area

Internal Medicine

Article Type

Original Study

Abstract

Objective The objective of this study was to evaluate the fu ncti onal and cosmetic results of reversed-flow posterior interosseous artery (PIA) flap for reconstruction of hand defects and to assess them by follow-up and physiotherapy. Background Reconstruction of soft-tissue defects in the hand needs a single-stage procedure that can provide well-vascularized graft coverage at the earliest to give the best functional result. Patients and methods This follow-up study that included 20 patients (16 male and four female) was carried out in Menoufia University, Plastic and Reconstructive Surgery Department, from March 2015 to January 2017, with assessment by a follow-up period of 12 months and physiotherapy. All our patients had PIA flap for coverage of the defects. The defects were due to post-traumatic raw areas in 15 cases, postburn deformities in two cases, postcongenital hand deformity surgeries in one case, and post-tumor ablation in two cases. The first webspace defect occurred most often and the largest flap was 10 × 12 cm2. The donor site was covered by split skin graft in 14 cases, and in six cases the donor site was directly closed. Results Regarding flap course and survival, 15 (75%) flaps passed uneventfully, four (20%) flaps suffered from venous congestion, and one (5%) flap showed ischemia. Three flaps (the ischemic flap and two congested flaps) suffered total loss. Two congested flaps survived without loss, and thus we had 17 (85%) survived flaps. All cases were satisfied with cosmetic outcome. Conclusion The reverse-flow flap based on PIA is a reliable and versatile source for coverage of complex soft-tissue defects in the hand.

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