Reverse Perforator Flaps in the Reconstruction of the Hand. Our Clinical Experience

Disclaimer: This article has been published immediately upon acceptance (by the Editors of the journal) as a provisional PDF from the revised version submitted by the authors(s). The final PDF version of this article will be available from the journal URL shortly after approval of the proofs by authors(s) and publisher. which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited. Abstract: Distant flaps are often used for the reconstruction of largest hand's defects and offer a great amount of skin without other donor site morbidity to the injured hand. In the forearm, cutaneous perforators of the radial artery supply a cutaneous territory of the radial forearm flap and the size and distribution of the vascular territory are relatively constant. In our experience we use three different reverse flaps in hand and fingers reconstruction: reversed forearm island flap, to cover dorsal and palmar cutaneous defects for trauma or malignancies in 12 patients; reverse forearm fasciosubcutaneous flap, to correct post burn scars in 5 patients; reverse metacarpal flap, to treat 13 patients with fingers skin defects. Except for one case of total flap loss, the morphological and functional results were satisfactory and no other procedures were used to obtain a well-healed cutaneous coverage. The distally based reverse fasciocutaneous flaps have proved to be a safe and simple procedure to cover serious defects of the hand and fingers. The incidence of complications is very low. The most important advantages are simple and quick procedure and the clinical safety.