Bilateral Pedicled Superficial Epigastric Flap in the Management of Circumferential Combined Degloving and Full Thickness Burn Hand Injury—A Case Report

Abstract

We report a case of combined hand trauma in the form of circumferential degloving injury of the hand with full thickness friction burns of the hand, forearm and the distal part of the upper arm. On exploration the hand was found avascular with loss of vital structures and full thickness burns. As a salvage procedure the hand was embedded in the subcutaneous tissue of the abdomen for 4 weeks and after that elevated as an inferiorly based flap on the bilateral superficial inferior epigastric arteries. Two weeks later the hand was freed by division of the base of the flap bilaterally. The details and description of the injury, the procedure and the outcome are discussed.

Share and Cite:

M. E. Habib and C. H. Reuter, "Bilateral Pedicled Superficial Epigastric Flap in the Management of Circumferential Combined Degloving and Full Thickness Burn Hand Injury—A Case Report," Modern Plastic Surgery, Vol. 2 No. 2, 2012, pp. 35-38. doi: 10.4236/mps.2012.22009.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] T. R. Stevenson, T. R. Hester, E. C. Duus and R. O. Dingman, “The Superficial Inferior Epigastric Artery Flap for Coverage of Hand and Forearm Defects,” Annals of Plastic Surgery, Vol. 12, No. 4, 1984, pp. 333-339. doi:10.1097/00000637-198404000-00005
[2] S. R. Sabapathy, H. Venkatramani, T. Giesen and A. S. Ullah, “Primary Bone Grafting with Pedicled Flap Cover for Dorsal Combined Injuries of the Digits,” Journal of Hand Surgery (European Volume), Vol. 33, No. 1, 2008, pp. 65-67. doi:10.1177/1753193407087868
[3] H. Dong, H.-W. Wang, H.-G. Wang, W.-Z. Wu and C.-Y. Zhao, “Reconstruction of Soft Tissue Defect of the Extremity with the Perforator Flap from the Inguinal Region,” Chinese Medical Journal, Vol. 122, No. 23, 2009, pp. 2861-2864.
[4] S. Nasr, M. A. Aydn, “Wide Combined Thin Free SCIA/ SIEA Flap,” Annals of Plastic Surgery, Vol. 61, No. 6, 2008, pp. 627-631. doi:10.1097/SAP.0b013e31816d82f5
[5] R. L. Thatte, U. A. Patil and L. D. Dhami, “The Combined Use of the Superficial External Pudendal Artery Flap with a Flap of the Anterior Rectus Sheath for the Simultaneous Cover of Dorsal and Volar Defects on the Hand,” British Journal of Plastic Surgery, Vol. 39, No. 3, 1986, pp. 321-326. doi:10.1016/0007-1226(86)90041-X
[6] H. F. Koncilia, A. P. Worseg, R. Kuzbari and J. Holle, “The Combined Use of a Pedicled Scarpa’s Fascia Flap and a Groin Flap for Simultaneous Coverage of Dorsal and Palmar Finger Defects,” Journal of Hand Surgery (European Volume), Vol. 22, No. 5, 1997, pp. 620-622. doi:10.1016/S0266-7681(97)80360-9
[7] J. Y. Choi and K. C. Chung, “The Combined Use of a Pedicled Superficial Inferior Epigastric Artery Flap and a Groin Flap for Reconstruction of a Dorsal and Volar Hand Blast Injury,” Hand, Vol. 3, No. 4, 375-380.
[8] A. M. Dorafshar, M. Januszyk and D. H. Song, “Anatomical and Technical Tips for Use of the Superficial Inferior Epigastric Artery (SIEA) Flap in Breast Reconstructive Surgery,” Journal of Reconstructive Microsurgery, Vol. 26, No. 6, 2010, pp. 381-389. doi:10.1055/s-0030-1249604
[9] C. Holm, M. Mayr, E. Hofter and M. Ninkovic, “The Versatility of the Siea Flap: A Clinical Assessment of the Vascular Territory of the Superficial Epigastric Inferior Artery,” Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 60. No. 8, 2007, pp. 946-951. doi:10.1016/j.bjps.2005.12.066

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.