Flap reconstruction in the upper limb.

Abstract

The introduction of the free flap and the regional fasciocutaneous flap has added to the methods of skin defect coverage in the upper limb and avoids the disadvantages of conventional flaps. This paper describes the features and indications of regional axial pattern flaps and free flaps for upper limb skin defects. They can be categorised into flaps in the ipsilateral upper limb and flaps from out of the upper limb. Flaps in the upper limb include the lateral arm flap, the radial forearm flap, the posterior interosseous artery flap, the dorsal metacarpal artery flap, and the digital artery flap. Flaps from out of the upper limb comprise the latissimus dorsi myocutaneous flap, the scapular flap, the groin flap and the hemipulp flap. Criteria for flap selection include the patient's age and health, the condition of the skin defects, the location and size of the defects and damage of the deep structure, the patient's cosmetic demand, the surgeon's technical skill and the facilities in the operating room.