Philandrianos C, Guinard D, Legré R
Service de chirurgie de la main et de chirurgie plastique et réparatrice des membres, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 05, France.
Chir Main. 2007 Aug-Oct;26(4-5):227-31. doi: 10.1016/j.main.2007.07.001. Epub 2007 Jul 30.
The authors report two cases of gunshot wounds to the hand treated with a double skin paddle reverse-flow forearm flap. The two cases, male and female, were due to a self-inflicted rifle injury. The wounds were severe and extensive with full-thickness palmar and dorsal skin, tendon, muscle, bone, vessel and nerve losses. Treatment was performed in a single stage with skeletal stabilization, bone grafting and nerve and tendon reconstruction. The double palmar and dorsal skin defect was reconstructed with a double skin paddle reverse-flow forearm flap which was routed through the hand wound. The forearm flap is the sole way, free flaps excepted, to achieve reliable hand dorsal and palmar coverage in a single stage. In addition, this technique simplifies the reconstruction by using a local flap and allows better management for healing and rehabilitation as compared to a multiple flap procedure.
