Abstract:

Objective To repair the hand skin and soft tissue defect with the reverse island forearm posterior interosseous flap, observe the outcomes and summarize the characteristics of flap and surgical experience. Methods The clinical data of 36 patients with hand skin and soft tissue defect repaired with the reverse island forearm posterior interosseous flap were collected. The flap location, flap design, surgical procedures and clinical outcomes were retrospectively analysed, and the characteristics of flap and surgical experience were summarized. Results Among the 36 patients, the skin and soft tissue defect involved region dorsalis manus (n=24), first web space (n=4), region volaris manus (n=4) and thumb (n=4). The sizes of flaps ranged from 4 cm×5 cm to 10 cm×14 cm, and the pedicle length ranged from 3.0 cm to 7.5 cm. There were 12 patients with 11 to 15 perforators, 20 patients with 5 to 10 perforators, and 4 patients with 1 to 4 perforators. The flaps were clinically viable in all the 36 patients (100%). Patients were followed up for 6 months to 12 months, and the flaps were similar to skin in texture and elasticity, and had reliable blood supply. All patients had a favorable functional recovery of hands. Conclusion The reverse island forearm posterior interosseous flap has a reliable blood supply, is easy to operate, and can be an ideal donor choice for repair of hand skin and soft tissue defect. The proper flap design may be the key to a successful operation.

Key words: reverse island forearm posterior interosseous flap, flap design, skin and soft tissue defect, hand