Volume 10, Issue 3 (7-2021)                   WJPS 2021, 10(3): 3-7 | Back to browse issues page

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Whitehouse H. Comparison of Thigh-Based versus Groin-Based versus Lateral-Thoracic-Based Flaps for Hand Resurfacing: A Review Article. WJPS. 2021; 10 (3) :3-7
URL: http://wjps.ir/article-1-811-en.html
Queen Mary University London, Mile End Rd, Bethnal Green, London E1 4NS , harry.whitehouse2015@gmail.com
Abstract:   (860 Views)
Thigh-based, groin-based and lateral-thoracic-based flaps are available for microsurgical hand resurfacing – which is the best?
BestBETS methodology was used to systematically evaluate the advantages and disadvantages. PubMed, EMBASE and Cochrane databases were searched up until Sep 2020, using the search strategy: hand re-surfacing, free-flap, groin-flap, thigh-flap, lateral thoracic-flap, advantages, and disadvantages.
Overall, 31 papers were identified which were used to synthesize the discussion and conclusions.
Thigh-based anterolateral thigh (ALT) flaps offer the greatest versatility.
Full-Text [PDF 204 kb]   (441 Downloads)    
Type of Study: case report | Subject: Special
Received: 2021/07/22 | Accepted: 2021/07/6 | Published: 2021/10/23

1. Lee K, Roh S, Lee D, Kim J. Skin coverage considerations in a mutilating hand injury. Hand Clin 2016 Nov 1;32(4):491-503. DOI: 10.1016/j.hcl.2016.07.002 [DOI:10.1016/j.hcl.2016.07.002]
2. Tare M, Ramakrishnan V. Free 'mini'groin flap for digital resurfacing. J Hand Surg Eur Vol 2009 Jun;34(3):336-42. DOI: 10.1177/1753193408101464 [DOI:10.1177/1753193408101464]
3. Lin CT, Chen LW. Surgical refinements and sensory recovery of using transverse sensate thoracodorsal artery perforator flaps to resurface ring-avulsed fingers. Ann Plast Surg 2014 Mar 1;72(3):299-306. DOI: 10.1097/SAP.0b013e31825c0a4a [DOI:10.1097/SAP.0b013e31825c0a4a]
4. Goh TL, Park SW, Cho JY, Choi JW, Hong JP. The search for the ideal thin skin flap: superficial circumflex iliac artery perforator flap-a review of 210 cases. Plas Reconstr Surg 2015 Feb 1;135(2):592-601. DOI: 10.1097/PRS.0000000000000951 [DOI:10.1097/PRS.0000000000000951]
5. Tang L, Pafitanis G, Yang P, Li Z, Jia M, Koshima I, Song D, Chi Z. Combined multi-lobed flaps: a series of 39 extensive hand and multi-digit injuries one-staged reconstructions using modified designs of ALT, DPA and chimeric linking flaps. Injury 2017 Jul 1;48(7):1527-35. DOI: 10.1016/j.injury.2017.03.049 [DOI:10.1016/j.injury.2017.03.049]
6. Rehim SA, Kowalski E, Chung KC. Enhancing aesthetic outcomes of soft tissue coverage of the hand. Plast Reconstr Surg 2015 Feb;135(2):413e. DOI: 10.1097/PRS.0000000000001069 [DOI:10.1097/PRS.0000000000001069]
7. Hocaoğlu E, Arıncı A, Berköz Ö, Özkan T. Free pre-expanded lateral circumflex femoral artery perforator flap for extensive resurfacing and reconstruction of the hand. J Plast Reconstr Aesthet Surg 2013 Dec 1;66(12):1788-91. DOI: 10.1016/j.bjps.2013.04.019 [DOI:10.1016/j.bjps.2013.04.019]
8. Engelhardt TO, Rieger UM, Schwabegger AH, Pierer G. Functional resurfacing of the palm: flap selection based on defect analysis. Microsurgery 2012 Feb;32(2):158-66. DOI: 10.1002/micr.20951 [DOI:10.1002/micr.20951]
9. Wei FC, Mardini S. Flaps and reconstructive surgery E-book. Elsevier Health Sciences 2016 Aug 26. pp 358-374
10. Watson AC, McGregor JC. The simultaneous use of a groin flap and a tensor fasciae latae myocutaneous flap to provide tissue cover for a completely degloved hand. Br J Plast Surg 1981 Jul 1;34(3):349-52. DOI: 10.1016/0007-1226(81)90029-1 [DOI:10.1016/0007-1226(81)90029-1]
11. Amouzou KS, Berny N, El Harti A, Diouri M, Chlihi A, Ezzoubi M. The pedicled groin flap in resurfacing hand burn scar release and other injuries: a five-case series report and review of the literature. Ann Burns Fire Disasters 2017 Mar 31;30(1):57. PMCID: PMC5446912
12. Graf P, Biemer E. Morbidity of the groin flap transfer: are we getting something for nothing? Br J Plast Surg 1992 Jan 1;45(2):86-8. DOI: 10.1016/0007-1226(92)90162-q [DOI:10.1016/0007-1226(92)90162-Q]
13. Goertz O, Kapalschinski N, Daigeler A, Hirsch T, Homann HH, Steinstraesser L, Lehnhardt M, Steinau HU. The effectiveness of pedicled groin flaps in the treatment of hand defects: results of 49 patients. J Hand Surg Am 2012 Oct 1;37(10):2088-94. DOI: 10.1016/j.jhsa.2012.07.014 [DOI:10.1016/j.jhsa.2012.07.014]
14. Al-Qattan MM, Al-Qattan AM. Defining the indications of pedicled groin and abdominal flaps in hand reconstruction in the current microsurgery era. J Hand Surg Am 2016 Sep 1;41(9):917-27. DOI: 10.1016/j.jhsa.2016.06.006 [DOI:10.1016/j.jhsa.2016.06.006]
15. Gupta P, Tawar RS, Malviya M. Groin Flap in Paediatric Age Group to Salvage Hand after Electric Contact Burn: Challenges and Experience. J Clin Diagn Res 2017 Aug;11(8):PC01. DOI: 10.7860/JCDR/2017/29124.10332 [DOI:10.7860/JCDR/2017/29124.10332]
16. Riesel JN, Giladi AM, Iorio ML. Volar resurfacing of the thumb with a superficial circumflex iliac artery perforator flap after hydrofluoric acid burn. J Hand Microsurg 2018 Dec;10(3):162. doi: 10.1055/s-0038-1630146 [DOI:10.1055/s-0038-1630146]
17. Suh HS, Jeong HH, Choi DH, Hong JP. Study of the medial superficial perforator of the superficial circumflex iliac artery perforator flap using computed tomographic angiography and surgical anatomy in 142 patients. Plast Reconstr Surg 2017 Mar 1;139(3):738-48. DOI: 10.1097/PRS.0000000000003147 [DOI:10.1097/PRS.0000000000003147]
18. Adani R, Tarallo L, Marcoccio I, Cipriani R, Gelati C, Innocenti M. Hand reconstruction using the thin anterolateral thigh flap. Plast Reconstr Surg 2005 Aug 1;116(2):467-73. DOI: 10.1097/01.prs.0000173059.73982.50 [DOI:10.1097/01.prs.0000173059.73982.50]
19. Adani R, Tarallo L, Marcoccio I, Fregni U. First web-space reconstruction by the anterolateral thigh flap. J Hand Surg Am 2006 Apr 1;31(4):640-6. DOI: 10.1016/j.jhsa.2005.12.009 [DOI:10.1016/j.jhsa.2005.12.009]
20. Wei FC, Jain V, Celik N, Chen HC, Chuang DC, Lin CH, Hallock GG. Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 2002 Jun 1;109(7):2219-26. DOI: 10.1097/00006534-200206000-00007 [DOI:10.1097/00006534-200206000-00007]
21. Ross GL, Dunn R, Kirkpatrick J, Koshy CE, Alkureishi LW, Bennett N, Soutar DS, Camilleri IG. To thin or not to thin: the use of the anterolateral thigh flap in the reconstruction of intraoral defects. Br J Plast Surg 2003 Jun 1;56(4):409-13. DOI: 10.1016/s0007-1226(03)00126-7 [DOI:10.1016/S0007-1226(03)00126-7]
22. Fox P, Endress R, Sen S, Chang J. Fascia-only anterolateral thigh flap for extremity reconstruction. Ann Plast Surg 2014 May 1;72:S9-13. DOI: 10.1097/SAP.0000000000000146 [DOI:10.1097/SAP.0000000000000146]
23. Koshima I, Fukuda H, Utunomiya R, Soeda S. The anterolateral thigh flap; variations in its vascular pedicle. Br J Plast Surg 1989 May 1;42(3):260-2. DOI: 10.1016/0007-1226(89)90142-2 [DOI:10.1016/0007-1226(89)90142-2]
24. Lin CT, Yang KC, Hsu KC, Liu WC, Chen JS, Chen LW. Sensate thoracodorsal artery perforator flap: a focus on its preoperative design and harvesting technique. Plast Reconstr Surg 2009 Jan 1;123(1):163-74. DOI: 10.1097/PRS.0b013e3181909c34 [DOI:10.1097/PRS.0b013e3181909c34]
25. Kim JT, Kim SK. Hand resurfacing with the superthin latissimus dorsi perforator-based free flap. Plast Reconstr Surg 2003 Jan 1;111(1):366-70. DOI: 10.1097/01.PRS.0000020995.12204.99 [DOI:10.1097/00006534-200301000-00064]
26. Kim SW, Lee HJ, Kim JT, Kim YH. Multiple-digit resurfacing using a thin latissimus dorsi perforator flap. J Plast Reconstr Aesthet Surg 2014 Jan 1;67(1):74-80. DOI: 10.1016/j.bjps.2013.10.007 [DOI:10.1016/j.bjps.2013.10.007]
27. Brody GA, Buncke HJ, Alpert BS, Hing DN. Serratus anterior muscle transplantation for treatment of soft tissue defects in the hand. J Hand Surg Am 1990 Mar 1;15(2):322-7. DOI: 10.1016/0363-5023(90)90117-a [DOI:10.1016/0363-5023(90)90117-A]
28. Ulrich D, Fuchs P, Bozkurt A, Pallua N. Free serratus anterior fascia flap for reconstruction of hand and finger defects. Arch Orthop Trauma Surg 2010 Feb 1;130(2):217-22. DOI: 10.1007/s00402-009-0845-5 [DOI:10.1007/s00402-009-0845-5]
29. Tropet Y, Brientini JM, Garbuio P, Ridoux PE, Vichard P. Reconstruction of a complex defect of the dorsum of the hand. J Hand Surg Am 1995 Oct;20(5):591-5. DOI: 10.1016/s0266-7681(05)80116-0 [DOI:10.1016/S0266-7681(05)80116-0]
30. Zelken JA, Chang NJ, Wei FC, Lin CH. The combined ALT-groin flap for the mutilated and degloved hand. Injury 2015 Aug 1;46(8):1591-6. DOI: 10.1016/j.injury.2015.05.022 [DOI:10.1016/j.injury.2015.05.022]
31. Senda H, Muro H, Terada S, Okamoto H. A case of degloving injury of the whole hand reconstructed by a combination of distant flaps comprising an anterolateral thigh flap and a groin flap. J Reconstr Microsurg 2011 Jun;27(05):299-302. DOI: 10.1055/s-0031-1278708 [DOI:10.1055/s-0031-1278708]
32. Xu L, Xu J, Shou K, Rui Y. Repair of avulsion injury of the whole hand with single-stage transfer of five combined tissues: case report. J Reconstr Microsurg 2003;19(02):079-84. DOI: 10.1055/s-2003-37810 [DOI:10.1055/s-2003-37810]
33. Fan CY, Jiang J, Zeng BF, Jiang PZ, Cai PH, Chung KC. Reconstruction of thumb loss complicated by skin defects in the thumb-index web space by combined transplantation of free tissues. J Hand Surg Am 2006 Feb 1;31(2):236-41. DOI: 10.1016/j.jhsa.2005.10.021 [DOI:10.1016/j.jhsa.2005.10.021]
34. Kim KS, Kim ES, Kim DY, Lee SY, Cho BH. Resurfacing of a totally degloved hand using thin perforator-based cutaneous free flaps. Ann Plast Surg 2003 Jan 1;50(1):77-81. DOI: 10.1097/00000637-200301000-00013 [DOI:10.1097/00000637-200301000-00013]
35. García-Sánchez JM, Beltrán LI, Simón-Sanz E, Cases AR, Salmerón-González E, Del Caz MD. Management of Hand Burn With Pedicled Converted Anterolateral Thigh Free Flap. Plast Surg Nurs 2019 Jan 1;39(1):14-7. DOI: 10.1097/PSN.0000000000000254 [DOI:10.1097/PSN.0000000000000254]
36. Zhang Z, Zhuang Y, Chen L. Application of pedicled anterolateral thigh flap transferring for coverage of oversized skin defect of hand. Chinese Journal of Reparative and Reconstructive Surgery 2006 Dec 1;20(12):1199-201. PMID: 17228680

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