The Versatility of Paraumbilical Perforator Flap in the Coverage of Large Posttraumatic Hand Defects

Background: The use of pedicled distant flaps remainsof significant importance in the reconstruction of the complexsoft tissue defects of the upper extremity.Objective: In this article, we present contralateral paraumbilicalperforator pedicled flap for reconstructing complexsoft tissue defects of the hand with or without distal forearm.Patients and Methods: Twenty patients (19 men, 1 woman)had contralateral paraumbilical perforator pedicled flaps forthe reconstruction of complex soft tissue defects of the handwith or without distal forearm. Patients' age ranged between16 and 52 years (mean age was 38.4 years). Flaps size,dimension and orientation were designed individually foreach defect and ultrasound Doppler was used for perforatormarking. Flap pedicle division was done after 3 weeks afterthe first operation. Donor areas were closed directly in allpatients with a follow up of 6-month duration.Results: In all the twenty cases, the flaps survived completelywithout having any major complication postoperativelyexcept for two cases of seroma, three cases of wound disruptionand only one case of distal flap necrosis. Flap dimensionsranged from 6x10 to 16x26cm. The surgical outcome wasfound to be functionally and aesthetically satisfactory duringthe follow-up period.Conclusion: Paraumbilical perforator pedicled flap is areliable surgical option for the reconstruction of complex softtissue defects of the hand with or without distal forearm. Thecontralateral paraumbilical perforator flap should be a considerablealternative in hand reconstruction due to its ease ofapplication, with no need for specialized equipment (noavailable microsurgery), low donor site morbidity with satisfactoryfunctional and aesthetic outcomes.