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The profunda artery perforator flap for upper limb reconstruction: A case report and literature review on the flap applications in reconstruction

The profunda femoris artery perforator (PAP) flap has been recently popularized as an alternative option for microsurgical reconstruction. The use of PAP flap has never been reported and described for reconstruction of the upper extremities, in particular the forearm. The purpose of this case report...

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Autores principales: Boriani, Filippo, Sassu, Paolo, Atzeni, Matteo, Buckley, Christina, Figus, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796947/
https://www.ncbi.nlm.nih.gov/pubmed/35876622
http://dx.doi.org/10.1002/micr.30941
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author Boriani, Filippo
Sassu, Paolo
Atzeni, Matteo
Buckley, Christina
Figus, Andrea
author_facet Boriani, Filippo
Sassu, Paolo
Atzeni, Matteo
Buckley, Christina
Figus, Andrea
author_sort Boriani, Filippo
collection PubMed
description The profunda femoris artery perforator (PAP) flap has been recently popularized as an alternative option for microsurgical reconstruction. The use of PAP flap has never been reported and described for reconstruction of the upper extremities, in particular the forearm. The purpose of this case report is to describe a case suggesting the PAP flap as a further reconstructive option in the upper limb. A 16‐year‐old girl who sustained a traumatic injury to her right dominant forearm resulting in subtotal circumferential tissue loss following a road traffic accident was referred to the authors' department 2 years post‐trauma. The disabling fibrotic sequelae on her volar forearm (15 × 10 cm) resulted in a nonfunctional hand. She was unable to perform any active movement of her wrist or digits. Passive movements in the finger joints were preserved. Following debridement and reconstruction of nerves and tendons, soft tissues were resurfaced with a PAP flap. The transverse skin paddle, 12 × 7 cm, was placed distally with the adipofascial portion positioned proximally above the muscle bellies and anastomoses site. A small raw area (4 × 3 cm) was covered with an acellular dermal matrix (ADM). The postoperative course was uneventful. At 9 months postoperatively, the patient demonstrated active flexion and extension of the fingers with independent function. The patient reported satisfaction with the flap donor site and forearm resurfacing. The PAP flap can be a further option for areas requiring soft tissue coverage in patients refusing visible scars. This flap had both the advantage of reducing the morbidity and visibility of the donor site, as well as the ability to resurface a large recipient site with soft and pliable tissue, covering exposed nerves and tendons.
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spelling pubmed-97969472023-01-04 The profunda artery perforator flap for upper limb reconstruction: A case report and literature review on the flap applications in reconstruction Boriani, Filippo Sassu, Paolo Atzeni, Matteo Buckley, Christina Figus, Andrea Microsurgery Case Reports The profunda femoris artery perforator (PAP) flap has been recently popularized as an alternative option for microsurgical reconstruction. The use of PAP flap has never been reported and described for reconstruction of the upper extremities, in particular the forearm. The purpose of this case report is to describe a case suggesting the PAP flap as a further reconstructive option in the upper limb. A 16‐year‐old girl who sustained a traumatic injury to her right dominant forearm resulting in subtotal circumferential tissue loss following a road traffic accident was referred to the authors' department 2 years post‐trauma. The disabling fibrotic sequelae on her volar forearm (15 × 10 cm) resulted in a nonfunctional hand. She was unable to perform any active movement of her wrist or digits. Passive movements in the finger joints were preserved. Following debridement and reconstruction of nerves and tendons, soft tissues were resurfaced with a PAP flap. The transverse skin paddle, 12 × 7 cm, was placed distally with the adipofascial portion positioned proximally above the muscle bellies and anastomoses site. A small raw area (4 × 3 cm) was covered with an acellular dermal matrix (ADM). The postoperative course was uneventful. At 9 months postoperatively, the patient demonstrated active flexion and extension of the fingers with independent function. The patient reported satisfaction with the flap donor site and forearm resurfacing. The PAP flap can be a further option for areas requiring soft tissue coverage in patients refusing visible scars. This flap had both the advantage of reducing the morbidity and visibility of the donor site, as well as the ability to resurface a large recipient site with soft and pliable tissue, covering exposed nerves and tendons. John Wiley & Sons, Inc. 2022-07-25 2022-10 /pmc/articles/PMC9796947/ /pubmed/35876622 http://dx.doi.org/10.1002/micr.30941 Text en © 2022 The Authors. Microsurgery published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Boriani, Filippo
Sassu, Paolo
Atzeni, Matteo
Buckley, Christina
Figus, Andrea
The profunda artery perforator flap for upper limb reconstruction: A case report and literature review on the flap applications in reconstruction
title The profunda artery perforator flap for upper limb reconstruction: A case report and literature review on the flap applications in reconstruction
title_full The profunda artery perforator flap for upper limb reconstruction: A case report and literature review on the flap applications in reconstruction
title_fullStr The profunda artery perforator flap for upper limb reconstruction: A case report and literature review on the flap applications in reconstruction
title_full_unstemmed The profunda artery perforator flap for upper limb reconstruction: A case report and literature review on the flap applications in reconstruction
title_short The profunda artery perforator flap for upper limb reconstruction: A case report and literature review on the flap applications in reconstruction
title_sort profunda artery perforator flap for upper limb reconstruction: a case report and literature review on the flap applications in reconstruction
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796947/
https://www.ncbi.nlm.nih.gov/pubmed/35876622
http://dx.doi.org/10.1002/micr.30941
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