DISTANT SOFT TISSUE FLAPS IN A DEGLOVING SKIN INJURY

Abstract

Avulsion skin injuries of the glove removal type are one of the most challenging and difficult problems in reconstructive hand surgery. Immediate or early coverage of the hand is of utmost importance. Several options are proposed for early covering the preserved structures (tendons, bones and nerves) early, mainly skin grafting on the preserved viable structures. Case description: We present a case of a patient with 4th and 5th finger crushing and avulsion skin injury of thumb and index finger and lost distal phalanges. The 4th and 5th fingers had been amputated due to gangrene. Two anterior abdominal wall flaps were applied: a thoraco-umbilical flap and a horizontal Filatov stem" flap. On the 25th day, the flaps were separated from the fingers and following commissuroplasty 10 months later. Result: Fusion between the donor flap and the recipient structures was obtained without clinical evidence of infection, ulceration and flap necrosis. Conclusions: The usage of remote skin flaps is a safe and simple method to restore hand function when microsurgery cannot be applied.

Keywords

• subcutaneous defects
• glove injury
• abdominoplasty
• thoraco-umbilical flap
• thoracoabdominal flap
• filatov's pedicle flap
• commissuroplasty