gms | German Medical Science

Objectives: Severe hand trauma with complex structure loss poses a great challenge for the hand reconstruction. Flap selection with a versatile donor site to avoid more donor site morbidity is crucial under the surgeon's consideration. According to the size of the skin defect and other structure loss of the hand, an economic donor site should be meticulously measured and selected.

Method: In a retrospective study of 11 cases, we used several donor sites (anterolateral thigh flap, deep inferioepigastric perforator flap,superficial iliac circumflex artery flap and latissimus dorsi myocutaneous flap) for the hand resurfacing and functional reconstruction together with the harvest of tendon,bone graft. Flow-through technique was introduced to restore the vascularity of the injured hand.

Results: All flaps survived completely. The size of the flaps ranged from 15x8 cm to 40x15 cm.All Patients were satisfied with the aesthetic and functional outcome of the reconstructed hand. 9 donor sites were closed primarily and the other 2 received a split thickness skin graft. Tendon and bone graft were harvested from the same donor site. The main vessel of two flaps were used to bridge a vascular defect to restore hand perfusion.

Conclusion: A versatile donor site selection can offer an economic solution for the hand reconstruction to have a low donor site morbidity.