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J Reconstr Microsurg 2005; 21(2): 85-91
DOI: 10.1055/s-2005-864840
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Arterialized Venous Flow-Through Flap for Simultaneous Reconstruction of a Radial Artery Defect and Palmar Forearm Soft-Tissue Loss from Sarcoma Resection

E. Gene Deune1 , Eduardo Rodriguez1 , Daniel Hatef2 , Frank Frassica3
  • 1Division of Plastic Surgery, Johns Hopkins School of Medicine, Baltimore, MD
  • 2University of Maryland School of Medicine, Baltimore, MD
  • 3Department of Orthopedics, Johns Hopkins School of Medicine, Baltimore, MD
Further Information

Publication History

Accepted: August 6, 2004

Publication Date:
28 February 2005 (online)

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ABSTRACT

A 50-year-old right-handed male presented with a previously incompletely excised low-grade fibrous histiocytoma on his distal radial palmar forearm. Reoperative wide resection resulted in a segmental defect of the radial artery and a large soft-tissue defect with exposed tendons denuded of paratenon. An arterialized venous fasciocutaneous flow-through flap, measuring 8 × 3 cm, was harvested from the dorsal ipsilateral hand and used to reconstruct both the soft-tissue and the segmental radial-artery defects. A full-thickness skin graft was harvested from the ipsilateral groin to cover the dorsal hand wound. Moderate venous congestion was noted in the flap on postoperative day 1 and treated with four days of leeches. Approximately 10 percent of the flap was lost due to the venous congestion. The flap healed well without further complications. At 33 months the flap remained well-perfused, with excellent flow through the reconstructed radial artery evidenced by both clinical examination and by color vascular Doppler exam. The patient had full range of motion in his right hand despite initial postoperative stiffness and reported no cold intolerance in the right hand. There has been no local recurrence of the sarcoma. The authors believe that this is the largest arterialized venous flow-through flap currently reported to have survived, as well as the first reported case of its use for the simultaneous reconstruction of a radial artery defect and an associated soft-tissue loss.

KEYWORDS

Arterialized - venous flow-through flap - radial artery - soft tissue sarcoma

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E. Gene DeuneM.D. 

Johns Hopkins School of Medicine, Division of Plastic Surgery

601 N. Caroline Street, 8152 B

Baltimore, MD 21287

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