Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverage

Background: While contemplating any difficult soft tissue reconstruction, patient comfort and compliance is of paramount importance. Reconstruction of the volar aspect of fingers and hand by the ipsilateral pedicled flaps (groin flap, abdominal flaps) is demanding as the flap inset is difficult for...

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Main Authors: Akram Hussain Bijli, Sheikh Adil Bashir, Altaf Rasool, Mir Yasir, Adil Hafeez Wani, Tanveer Ahmad, Mushtaq Ahmad
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2017-05-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_13_17
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author Akram Hussain Bijli
Sheikh Adil Bashir
Altaf Rasool
Mir Yasir
Adil Hafeez Wani
Tanveer Ahmad
Mushtaq Ahmad
author_facet Akram Hussain Bijli
Sheikh Adil Bashir
Altaf Rasool
Mir Yasir
Adil Hafeez Wani
Tanveer Ahmad
Mushtaq Ahmad
author_sort Akram Hussain Bijli
collection DOAJ
description Background: While contemplating any difficult soft tissue reconstruction, patient comfort and compliance is of paramount importance. Reconstruction of the volar aspect of fingers and hand by the ipsilateral pedicled flaps (groin flap, abdominal flaps) is demanding as the flap inset is difficult for the surgeon and very uncomfortable for the patient. This often leads to flap complications. For the comfort of the patient, better compliance and ease of complete inset, we planned to manage soft tissue defects of the volar aspect of fingers and hand by a new contralateral pedicled lumbo-umbilical flap. This flap is based on the paraumbilical perforators of deep inferior epigastric artery. Materials and Methods: The contralateral pedicled lumbo-umbilical flap was used in eight patients with high-tension electrical burn injuries involving the volar aspect of fingers and hand. The patients were closely observed for first 6 weeks for any flap or donor site complications and then followed monthly to assess donor and recipient site characteristics for 6 months to 2 years. Results and Conclusion: Large flaps up to 8 cm × 16 cm were raised. All but one flaps survived completely. All patients were mobilised within 48 h and five were discharged in less than a week after initial inset. The flap is reliable, easy to harvest and easy to inset on the volar aspect of fingers. The arm is positioned in a very comfortable position. The main disadvantage, however, is a conspicuous abdominal scar.
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issn 0970-0358
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language English
publishDate 2017-05-01
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
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spelling doaj-art-3792071a3a47447fb7c791a3bc0b8bf32025-08-20T01:56:32ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2017-05-01500220120610.4103/ijps.IJPS_13_17Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverageAkram Hussain Bijli0Sheikh Adil Bashir1Altaf Rasool2Mir Yasir3Adil Hafeez Wani4Tanveer Ahmad5Mushtaq Ahmad6Department of Plastic and Reconstructive Surgery, SKIMS, Srinagar, Jammu and Kashmir, IndiaDepartment of Plastic and Reconstructive Surgery, SKIMS, Srinagar, Jammu and Kashmir, IndiaDepartment of Plastic and Reconstructive Surgery, SKIMS, Srinagar, Jammu and Kashmir, IndiaDepartment of Plastic and Reconstructive Surgery, SKIMS, Srinagar, Jammu and Kashmir, IndiaDepartment of Plastic and Reconstructive Surgery, SKIMS, Srinagar, Jammu and Kashmir, IndiaDepartment of Plastic and Reconstructive Surgery, SKIMS, Srinagar, Jammu and Kashmir, IndiaDepartment of Plastic and Reconstructive Surgery, SKIMS, Srinagar, Jammu and Kashmir, IndiaBackground: While contemplating any difficult soft tissue reconstruction, patient comfort and compliance is of paramount importance. Reconstruction of the volar aspect of fingers and hand by the ipsilateral pedicled flaps (groin flap, abdominal flaps) is demanding as the flap inset is difficult for the surgeon and very uncomfortable for the patient. This often leads to flap complications. For the comfort of the patient, better compliance and ease of complete inset, we planned to manage soft tissue defects of the volar aspect of fingers and hand by a new contralateral pedicled lumbo-umbilical flap. This flap is based on the paraumbilical perforators of deep inferior epigastric artery. Materials and Methods: The contralateral pedicled lumbo-umbilical flap was used in eight patients with high-tension electrical burn injuries involving the volar aspect of fingers and hand. The patients were closely observed for first 6 weeks for any flap or donor site complications and then followed monthly to assess donor and recipient site characteristics for 6 months to 2 years. Results and Conclusion: Large flaps up to 8 cm × 16 cm were raised. All but one flaps survived completely. All patients were mobilised within 48 h and five were discharged in less than a week after initial inset. The flap is reliable, easy to harvest and easy to inset on the volar aspect of fingers. The arm is positioned in a very comfortable position. The main disadvantage, however, is a conspicuous abdominal scar.http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_13_17finger defectgroin flaphand defecthigh-tension electric burnlumbo-umbilical flapparaumbilical perforators
spellingShingle Akram Hussain Bijli
Sheikh Adil Bashir
Altaf Rasool
Mir Yasir
Adil Hafeez Wani
Tanveer Ahmad
Mushtaq Ahmad
Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverage
Indian Journal of Plastic Surgery
finger defect
groin flap
hand defect
high-tension electric burn
lumbo-umbilical flap
paraumbilical perforators
title Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverage
title_full Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverage
title_fullStr Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverage
title_full_unstemmed Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverage
title_short Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverage
title_sort contralateral lumbo umbilical flap a versatile technique for volar finger coverage
topic finger defect
groin flap
hand defect
high-tension electric burn
lumbo-umbilical flap
paraumbilical perforators
url http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_13_17
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AT altafrasool contralaterallumboumbilicalflapaversatiletechniqueforvolarfingercoverage
AT miryasir contralaterallumboumbilicalflapaversatiletechniqueforvolarfingercoverage
AT adilhafeezwani contralaterallumboumbilicalflapaversatiletechniqueforvolarfingercoverage
AT tanveerahmad contralaterallumboumbilicalflapaversatiletechniqueforvolarfingercoverage
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