Evolution of free flap reconstruction in the upper extremity: perspective from a tertiary plastic and reconstructive institution

Soft tissue reconstruction of the upper extremity requires consideration of wound bed status, varied anatomic composition, future function and tissue match, whether in thickness, pliability or involvement of other tissue components. Of the options available, microvascular free tissue flaps allow max...

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Bibliographic Details
Published in:Journal of Hand Surgery (European Volume) 2024-01, Vol.49 (1), p.8-16
Main Authors: Wu, Robin T., Lin, Chih-Hung, Hsu, Chung-Chen, Wei, Fu-Chan
Format: Article
Language:English
Subjects:
Esthetics
Free Tissue Flaps - blood supply
Humans
Perforator Flap - surgery
Plastic Surgery Procedures
Soft Tissue Injuries - surgery
Upper Extremity - surgery
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Summary:Soft tissue reconstruction of the upper extremity requires consideration of wound bed status, varied anatomic composition, future function and tissue match, whether in thickness, pliability or involvement of other tissue components. Of the options available, microvascular free tissue flaps allow maximal customizability with the avoidance of long-term donor site morbidity. Free tissue transfers have evolved, given increased surgical proficiency, from direct vessel-based flaps to septocutaneous vessel-based flaps, to musculocutaneous perforator flaps, and most recently to free-style free flaps. With increases in technical complexity come limitless alternatives. We documented the progression of free flap upper extremity reconstruction in recreating form and function of the upper extremity. The foundations laid should allow surgeons the freedom and versatility to choose the most faithful restoration of the defect and produce the best functional and aesthetic results.
ISSN:1753-1934
2043-6289
DOI:10.1177/17531934231181995