Arif Baig Mirza, Ijaz Hussain Shah, Muhammad Hussain, Muhammad Bilal Saeed, Ahmad Ali, Naheed Ahmed.
Reverse flow posterior interosseous artery flap: a safe technique for reconstruction of wrist and hand defects.
Isra Med J Jan ;11(6):434-8.

Objective: To assess safety of Reverse Flow Posterior Interosseous Artery Flap in wrist and hand reconstruction regarding its complications. Objective: To assess safety of Reverse Flow Posterior Interosseous Artery Flap in wrist and hand reconstruction regarding its complications. Study Design: Descriptive longitudinal study Study Design: Descriptive longitudinal study Place and Duration: Department of Plastic surgery and Burn Centre, Nishtar Medical University, Multan, 1st July 2016 to 30th June 2018. Place and Duration: Department of Plastic surgery and Burn Centre, Nishtar Medical University, Multan, 1st July 2016 to 30th June 2018. Methodology: Total 70 patients from both sex were included after taking Informed consent. The reverse flow PIA flap was performed under general anesthesia. The donor site was closed by using a partial thickness graft of skin from thigh. All patients were discharged after seven days. In next twenty one days patients were followed on weekly basis. At each follow-up, any complications like Flap necrosis, Infection, seroma or hematoma and poor aesthetic outcome of flap and donor site were examined. Methodology: Total 70 patients from both sex were included after taking Informed consent. The reverse flow PIA flap was performed under general anesthesia. The donor site was closed by using a partial thickness graft of skin from thigh. All patients were discharged after seven days. In next twenty one days patients were followed on weekly basis. At each follow-up, any complications like Flap necrosis, Infection, seroma or hematoma and poor aesthetic outcome of flap and donor site were examined. Results: In this series out of 70 cases complete flap survival were noted in 84.28% patients, in 1.4% patient there was marginal loss. Partial loss of PIA flaps in 11.4% cases and there was complete PIA flap loss in 2.85% patients. Infection was noted in 7.1% patient, Seroma in 2.85%, hematoma in 4.3%, Congestion in 7.1%. In 7.1% patients there was graft loss; whereas 8.6% developed aesthetic problem (contour irregularity) of the donor-site during the early postoperative period. Rest of 84.3% patients had no donor-site complications. Results: In this series out of 70 cases complete flap survival were noted in 84.28% patients, in 1.4% patient there was marginal loss. Partial loss of PIA flaps in 11.4% cases and there was complete PIA flap loss in 2.85% patients. Infection was noted in 7.1% patient, Seroma in 2.85%, hematoma in 4.3%, Congestion in 7.1%. In 7.1% patients there was graft loss; whereas 8.6% developed aesthetic problem (contour irregularity) of the donor-site during the early postoperative period. Rest of 84.3% patients had no donor-site complications. Conclusion: The Posterior Interosseous Artery (PIA) flap has very few post-operative complications when used for the coverage of the wounds of the wrist and hand. Conclusion: The Posterior Interosseous Artery (PIA) flap has very few post-operative complications when used for the coverage of the wounds of the wrist and hand.

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