THE ARTERIALIZED ANTEBRACHIAL SKIN FLAP FOR HAND RECONSTRUCTION

The authors present 20 microvascular flaps based on arteriovenous perf usion, harvested from the distal anterior forearm, and configured in t hree different designs. Indications were small palmar. dorsal, and com missural defects, when other conventional procedures were not availabl e; problematic cases of open reduction internal fixation with skin def ect; and when aggressive rehabilitation was needed. The follow-up vari ed between 6 and 28 months. Some degree of vascular congestion was obs erved in 100 percent of the flaps, and those changes were classified i n a progressive form. Coverage was judged as stable, thin, and pliable in 75 percent of the cases in the series; aggressive rehabilitation w as started promptly in all cases where this was possible. On average, an additional 2.4 hr were required for the original procedure. This fl ap demands little technical expertise for any microsurgical surgeon, a nd does not sacrifice any important donor vessel. The flap should not be followed-up by conventional monitoring methods; instead, simple pal pation of the pulse, Doppler auscultation, or PPG are required.