Background: The use of pedicled distant flaps remains
of significant importance in the reconstruction of the complex
soft tissue defects of the upper extremity.
Objective: In this article, we present contralateral paraumbilical
perforator pedicled flap for reconstructing complex
soft tissue defects of the hand with or without distal forearm.
Patients and Methods: Twenty patients (19 men, 1 woman)
had contralateral paraumbilical perforator pedicled flaps for
the reconstruction of complex soft tissue defects of the hand
with or without distal forearm. Patients' age ranged between
16 and 52 years (mean age was 38.4 years). Flaps size,
dimension and orientation were designed individually for
each defect and ultrasound Doppler was used for perforator
marking. Flap pedicle division was done after 3 weeks after
the first operation. Donor areas were closed directly in all
patients with a follow up of 6-month duration.
Results: In all the twenty cases, the flaps survived completely
without having any major complication postoperatively
except for two cases of seroma, three cases of wound disruption
and only one case of distal flap necrosis. Flap dimensions
ranged from 6x10 to 16x26cm. The surgical outcome was
found to be functionally and aesthetically satisfactory during
the follow-up period.
Conclusion: Paraumbilical perforator pedicled flap is a
reliable surgical option for the reconstruction of complex soft
tissue defects of the hand with or without distal forearm. The
contralateral paraumbilical perforator flap should be a considerable
alternative in hand reconstruction due to its ease of
application, with no need for specialized equipment (no
available microsurgery), low donor site morbidity with satisfactory
functional and aesthetic outcomes.