Alternative Flap Options for Upper Extremity Reconstruction

Yanis Berkane; Riccardo Giorgino; Zhi Yang Ng; Ruben Dukan; Alexandre G Lellouch

doi:10.1016/j.hcl.2023.08.010

Alternative Flap Options for Upper Extremity Reconstruction

Hand Clin. 2024 May;40(2):291-299. doi: 10.1016/j.hcl.2023.08.010. Epub 2023 Sep 9.

Authors

Yanis Berkane¹, Riccardo Giorgino², Zhi Yang Ng³, Ruben Dukan⁴, Alexandre G Lellouch⁵

Affiliations

¹ Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France; Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; UMR U1236-MICMAC, Immunology and Cell Therapy Lab, Rennes University Hospital, 2 Rue Henri Le Guillou, 35000 Rennes, France.
² Residency Program in Orthopaedics and Traumatology, University of Milan, Via Cristina Belgioioso, 173, 20161 Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso, 173, 20161 Milan, Italy; Plastic Surgery Research Laboratory, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA.
³ Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 9DU, UK.
⁴ Department of Hand, Upper Limb & Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), 20 Rue Leblanc, Paris, France.
⁵ Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; Department of Plastic, Reconstructive & Aesthetic Surgery, Georges-Pompidou European Hospital (HEGP), University of Paris, 20 Rue Leblanc, Paris, France; Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, F-75006, Paris, France. Electronic address: alellouch@mgh.harvard.edu.

PMID: 38553100
DOI: 10.1016/j.hcl.2023.08.010

Abstract

For major upper limb defects, a wide range of established pedicled and free flap options can be used. These include the latissimus dorsi/thoracodorsal artery perforator, lateral arm, posterior interosseous artery, rectus abdominis, gracilis, and anterolateral thigh flaps. Technical proficiency is essential, and favorable success rates in terms of functional and esthetic outcomes can be achieved. Herein, alternative flap options (both pedicled and free) are introduced and discussed through a few illustrative case examples.

Keywords: DIEP flap; Flap reconstruction; Microsurgical reconstruction; SCIP flap; Upper extremity.

Publication types

Review

MeSH terms

Arteries
Free Tissue Flaps* / blood supply
Humans
Perforator Flap* / blood supply
Plastic Surgery Procedures*
Superficial Back Muscles*
Treatment Outcome
Upper Extremity / surgery