Faisal Ashfaq.
Upper extremity burn reconstruction with reverse flow flaps: indications and utility.
Pak J Surg Jan ;29(3):195-8.

Introduction: In the extremity, reverse fl aps are transposed from proximal to distal locations. Th is article aims to observe their safety and reliability in upper extremity burn reconstruction. Material and methods: case records of all patients with burns who underwent reconstruction with reverse fl ow fl aps were reviewed. Th eir indications, complications and fi nal outcome in terms of aesthetics and function were assessed. Results: 22 patients were identifi ed from September 2010 to January 2013 and operated in Bolan medical complex, Quett a by a single surgeon. Th ere were 17 males and fi ve females. 24 diff erent fl aps were used. Five reverse lateral arm fl aps were used to reconstruct elbow defects and all of them survived. Reverse radial artery forearm fl ap was used in eight cases for dorsum of hand defects and only one marginal necrosis observed due to faulty closure under tension. Reverse posterior interosseous artery fl ap was used in eight cases; three for fi rst web space, one for ulnar border of wrist, two for palmar aspect of wrist, and one for thumb and fourth web space each. Two fl aps failed completely. Th ree dorsoulnar fl aps were used to reconstruct palmar aspect of wrist and palm and only one fl ap suffered marginal necrosis. . Functional and cosmetic results concerning the recipient and donor areas were found to be satisfactory. Conclusions: Despite some complications, it was concluded that reverse fl aps are versatile tools in the coverage of all kind of defects in the upper limb burns and should be thought of in the first place.

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