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      Reconstruction of Dorsal Hand Burn Scars Using Microdissected Tailoring of the Free Anterolateral Thigh Flap

      case-report

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          Abstract

          Background:

          Currently, large defects of the dorsum and finger of the hand pose a great challenge to plastic surgeons. The most difficult problem is finding a suitable material that has a large area and a thin, reliable blood supply and can be tailored into many small flaps to cover the fingers.

          Case series:

          We present the cases of two patients admitted to our hospital with scars on the dorsal side of the hand after gas burns. The defects after scar release were reconstructed by microdissected tailoring of the free anterolateral thigh flap. Complete survival was achieved for all flaps, including the small flaps tailored for finger defects. The function and aesthetics of the hands significantly improved. The patients were satisfied after the pain, itching, and burning symptoms of the scar were relieved.

          Conclusion:

          Microdissected tailoring of the free anterolateral thigh flap is an ideal method for addressing hand defects. The microdissected tailoring technique allows the surgeon to construct a thin flap with a reliable blood supply from the perforator.

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          Most cited references11

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          The free thigh flap: a new free flap concept based on the septocutaneous artery.

          Based on the septocutaneous artery flap concept, the thigh, which is the commonest conventional donor site for split-skin grafts, can also become a donor area for skin flaps. The thigh flap, with its large and long neuro-vascular pedicle, can be used either as a free flap or as an island flap as an alternative to the lower abdominal flap, groin flap, tensor fasciae latae myocutaneous flap, sartorius myocutaneous flap or the gracilis myocutaneous flap. The anatomical basis, operative technique and characteristics of the thigh flap are discussed.
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            Clinical application of the free thin anterolateral thigh flap in 31 consecutive patients.

            In this retrospective study, 31 reconstructions using thin anterolateral thigh flaps and six cadaveric dissections of the thigh were investigated in consideration of the anatomic variations of the perforator vessels in the adipose layer, the safe area of flap circulation, and the clinical indications. Three variations of the perforator vessel course in the adipose layer were predicted correctly. The safe radius of a thin anterolateral thigh flap with a thickness of 3 to 4 mm was determined to be approximately 9 cm from the point where the perforator met the skin. The use of a thin anterolateral thigh flap for reconstruction of the neck, axilla, anterior tibial area, dorsum of the foot, circumference on the ankle, forearm, and dorsum of the hand was therefore recommended.
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              • Record: found
              • Abstract: not found
              • Article: not found

              Microdissected thin perforator flaps: 46 cases.

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                Author and article information

                Journal
                Acta Inform Med
                Acta Inform Med
                Acta Informatica Medica
                Academy of Medical sciences (Bosnia and Herzegovina )
                0353-8109
                1986-5988
                June 2022
                : 30
                : 2
                : 125-128
                Affiliations
                [1] 1Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam
                [2] 2Department of Plastic and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam
                [3] 3Department of Plastic Surgery, Saint Paul General Hospital, Hanoi, Vietnam
                [4] 4Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
                Author notes
                Corresponding author: Nguyen-Vu Hoang, MD. Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam. nvuhoangmd@ 123456gmail.com . ORCID ID: 0000-0001-7079-2734.
                Article
                AIM-30-125
                10.5455/aim.2022.30.125-128
                9233477
                257d2178-9024-4fea-a6e9-956afc4d503e
                © 2022 Tran Thiet Son, Nguyen-Vu Hoang, Pham-Thi Viet Dung, Phan-Van Tan, Truong The Duy, Nguyen Minh Duc

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 March 2022
                : 06 June 2022
                Categories
                Case Series

                Bioinformatics & Computational biology
                burn scar,anterolateral thigh flap,hand reconstruction,thin flap,microdissected tailoring

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