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  • Baez, Antonio  (3)
  • 1
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Plastic and Reconstructive Surgery - Global Open Vol. 10, No. 9 ( 2022-09), p. e4539-
    In: Plastic and Reconstructive Surgery - Global Open, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 9 ( 2022-09), p. e4539-
    Abstract: Since its inception, the great toe pulp (GTP) flap has represented a valid therapeutic choice in the reconstruction of defects of the hand. This study illustrates the clinical outcomes of GTP free flaps performed without nerve anastomosis‚ mainly for fingertip defect reconstruction. Methods: We performed a retrospective, monocentric cohort study. All patients included in this study presented with fingertip traumatic injury, with tendon or bone exposure; reconstruction with GTP flap, without nerve reconstruction, was performed by the first author (L.T.) from May 2019 to October 2021. Results: All 37 flaps survived completely. Due to COVID restrictions‚ we had to send the tests and PROMs to our patients; 28 of them replied. Cold intolerance was reported by 12 patients (moderate in two cases and mild in ten cases). No pain was complained about either in hand or donor site (Visual Analog Score 0, at rest and at movement). Complete range of motion was achieved in 22 of 28 patients. All flaps recovered protective sensitivity. In every section of the Michigan Hand Outcome Questionnaire, all patients expressed a high level of satisfaction based on the reconstruction’s function and aesthetics. Regarding the donor site morbidity, no patient complained about gait disturbance. Conclusions: This study showed that the GTP flap is the optimal choice for fingertip reconstruction, providing excellent functional and aesthetic results with durable and glabrous skin, satisfactory pulp contour, and sensory restoration. These results could be achieved with no need for nerve suture, especially in defects with no injuries proximal to the loss of substance.
    Type of Medium: Online Resource
    ISSN: 2169-7574
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2723993-7
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  • 2
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Plastic and Reconstructive Surgery - Global Open Vol. 10, No. 9 ( 2022-09), p. e4538-
    In: Plastic and Reconstructive Surgery - Global Open, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 9 ( 2022-09), p. e4538-
    Abstract: Acquired soft-tissue defects of the hand can be a result of different types of trauma, infection, tumor resection, or burns. The evolution of the design and types of flaps have optimized the reconstruction and, nowadays, it is important to achieve not only a functional result but also an aesthetic result. The aim of the present study is to propose a model for treating a wide variety of skin defects in the hands based on our flap experience. Methods: We conducted a retrospective study from February 2019 to January 2022, which included all patients who underwent a skin flap for hand reconstruction. Patients’ medical records were reviewed and data collected included demographics, smoking status, presence of risk factors, type of trauma, flap reconstruction, dimensions, reoperations, and long-term complications. Results: A total of 99 patients underwent skin flap-based reconstruction for hand trauma between February 2019 until January 2022. The mean age was 43.9 (range 38.3–49.5), 87.9% of patients were male, and follow-up was between 2 and 30 months; 90.9% of the flaps were free flaps, and the rest were pedicle flaps (3% of them being propeller flaps). Conclusions: When planning a hand reconstruction, it is vital to ensure that the outcomes are not only functional but also aesthetic, with minimum donor site morbidity; in this study, we showed a variety of flaps that can be applied to achieve this goal. We believe that the final decision should be made after comprehending the defect and the patient’s preferences.
    Type of Medium: Online Resource
    ISSN: 2169-7574
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2723993-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 3
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Plastic and Reconstructive Surgery - Global Open Vol. 10, No. 9 ( 2022-09), p. e4537-
    In: Plastic and Reconstructive Surgery - Global Open, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 9 ( 2022-09), p. e4537-
    Abstract: The use of the radial artery (RA) as a recipient vessel in the hand is mainly described in the snuffbox. However, we believe that employing the RA distally to the extensor pollicis longus (EPL) tendon may provide remarkable advantages. Methods: We conducted a prospective study from June 2019 until December 2021, which included all patients who underwent reconstructive procedures with the RA distally to the snuffbox as the recipient vessel. We reviewed patients’ medical records: demographics, type of trauma, defect characteristics, microsurgical procedure, reoperations, and short- and long-term complications. Results: We found 23 patients eligible for this study; 22 patients required a reconstructive procedure due to a trauma and one for a congenital malformation. RA distal to snuffbox was always identified and judged reliable and apt as a recipient vessel. There were no issues with the anastomosis and no total flap failure in all cases. The morbidity in the recipient area was also minimal, with no mobility deficits, loss of sensation, or neuroma development. Conclusions: The RA is the primary vessel in the dorsum of the distal upper limb; performing the anastomosis distally to the EPL tendon may offer various advantages, making the surgery safer and less invasive.
    Type of Medium: Online Resource
    ISSN: 2169-7574
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2723993-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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