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Original Article 


Challenging Difficulties of Flap Reconstruction in the Hand

Gokce Yildiran, Erden Erkut Erkol, Mustafa Sutcu, Osman Akdag, Zekeriya Tosun.

Abstract
In reconstructive hand surgery, flaps and therefore microsurgical techniques are inevitable to provide the best functional and aesthetic results. There are various complications of defect repair with microsurgical methods. We aimed to classify subacute and late unexpected complications that develop after defect repair by microsurgical methods and to present the management.
Patients who underwent microvascular flap surgery for upper extremity tissue defects between 2014-2018 were included in the study. Complications other than total flap loss were retrospectively investigated and recorded.
8 patients (6 Male, 2 Female) were included to the study. 5 left and 3 right hand defects were detected. 3 fingers, 3 hand dorsum, 1 wrist and 1 forearm defects were detected. 2 marginal necrosis, 2 partial flap loss, 1 venous insufficiency, 1 nonunion, 1 skin contracture and 1 burn were the determined complications.
Most defects present with different traumas in hand. The trauma zone is almost always close to the area of microvascular repair, moreover the recipient artery may not always be intact. How the bone fixation is performed is very important, covering the bone should be provided with well-blooded tissues. While providing all these, this coverage should not be bulk and should not restrict the range of motion in the hand. Having grasping function necessitates a repair that puts the function in the foreground compared to other areas in the body. Subclinical infections of hand in patients presenting with post-traumatic defects may cause nutritional problems, which may impair wound healing. Such a problem can also be confused with the arterial deprivation of the flap. The absolute sense requirement distinguishes the hand area from the reconstruction of many areas. All these are challenging difficulties in choosing flap for defects in the hand.

Key words: complication, flap, hand, reconstruction


 
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How to Cite this Article
Pubmed Style

Yildiran G, Erkol EE, Sutcu M, Akdag O, Tosun Z, . Challenging Difficulties of Flap Reconstruction in the Hand. Hand Microsurg. 2021; 10(2): 116-126. doi:10.5455/handmicrosurg.137488


Web Style

Yildiran G, Erkol EE, Sutcu M, Akdag O, Tosun Z, . Challenging Difficulties of Flap Reconstruction in the Hand. http://handmicrosurgeryjournal.com/?mno=137488 [Access: August 19, 2021]. doi:10.5455/handmicrosurg.137488


AMA (American Medical Association) Style

Yildiran G, Erkol EE, Sutcu M, Akdag O, Tosun Z, . Challenging Difficulties of Flap Reconstruction in the Hand. Hand Microsurg. 2021; 10(2): 116-126. doi:10.5455/handmicrosurg.137488



Vancouver/ICMJE Style

Yildiran G, Erkol EE, Sutcu M, Akdag O, Tosun Z, . Challenging Difficulties of Flap Reconstruction in the Hand. Hand Microsurg. (2021), [cited August 19, 2021]; 10(2): 116-126. doi:10.5455/handmicrosurg.137488



Harvard Style

Yildiran, G., Erkol, E. E., Sutcu, M., Akdag, O., Tosun, Z. & (2021) Challenging Difficulties of Flap Reconstruction in the Hand. Hand Microsurg, 10 (2), 116-126. doi:10.5455/handmicrosurg.137488



Turabian Style

Yildiran, Gokce, Erden Erkut Erkol, Mustafa Sutcu, Osman Akdag, Zekeriya Tosun, and . 2021. Challenging Difficulties of Flap Reconstruction in the Hand. Hand and Microsurgery, 10 (2), 116-126. doi:10.5455/handmicrosurg.137488



Chicago Style

Yildiran, Gokce, Erden Erkut Erkol, Mustafa Sutcu, Osman Akdag, Zekeriya Tosun, and . "Challenging Difficulties of Flap Reconstruction in the Hand." Hand and Microsurgery 10 (2021), 116-126. doi:10.5455/handmicrosurg.137488



MLA (The Modern Language Association) Style

Yildiran, Gokce, Erden Erkut Erkol, Mustafa Sutcu, Osman Akdag, Zekeriya Tosun, and . "Challenging Difficulties of Flap Reconstruction in the Hand." Hand and Microsurgery 10.2 (2021), 116-126. Print. doi:10.5455/handmicrosurg.137488



APA (American Psychological Association) Style

Yildiran, G., Erkol, E. E., Sutcu, M., Akdag, O., Tosun, Z. & (2021) Challenging Difficulties of Flap Reconstruction in the Hand. Hand and Microsurgery, 10 (2), 116-126. doi:10.5455/handmicrosurg.137488








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