FREE AND ISLAND FLAP TRANSFER FOR SOFT-TISSUE DEFECTS IN THE HAND ANDFOREARM

Two hundred twenty patients with soft tissue defects in the hand and f orearm were treated with 226 free and island flap transfers. Reconstru cted sites involved the thumb in 74 cases, the fingers in 117, the han d in 30, and the forearm in 5. Seventy-nine patients received 82 free flaps, and 141 patients received 144 island flaps. Fifty-six finger re construction cases and 73 of 74 thumb reconstruction cases had sensory flap transfers, In the free flap transfer group, 77 flaps survived (9 3.9%), and 5 failed. In the island flap transfer group, 140 flaps surv ived (97.2%), and 4 failed. Of the five-failures in the free flap tran sfers, four were dorsalis pedis flaps, two of which were on patients w ith an arteriovenous fistula. Of the four failures in the island flap transfers, two were posterior interosseous flaps and two were digital island flaps. All four were reverse-flow island flaps. (C) 1996 Wiley- Liss, Inc.