ABSTRACT
Injuries to upper limb has been on the increase and is invariably associated with
significant soft tissue loss requiring a flap cover. Local tissue may not be available
for cover in a majority of situations, necessitating import of tissue from a distant
source. We have utilized the thoraco-umbilical flap taken from the trunk for this
purpose. This flap is based on the perforators of the deep inferior epigastric artery
that are maximally centred on the periumbilical region. This flap was used in 83 patients.
The patients were observed for at least 3 weeks and any flap or donor site complications
were recorded. The patients were again followed up at 3 months interval and the donor
site scar was assessed. The flaps survived in 81 patients; there was marginal flap
necrosis in five patients and partial flap necrosis in two patients. None of these
patients required any additional procedure for coverage. The flap is technically easy
to plan, almost effortless to drape around upper limb defects, with no significant
donor site morbidity and also the post operative immobilization was fairly comfortable.
The thoraco-umbilical flap thus is a very useful technique for coverage of the upper
limb and is recommended as a first line flap for this purpose.
KEY WORDS
Upper limb soft tissue defects - thoraco-umbilical flap - periumbilical perforators
- deep inferior epigastric artery
