Hirase Y, Kojima T, Bang H H
Department of Plastic and Reconstructive Surgery, Jikei University School of Medicine, Tokyo, Japan.
Plast Reconstr Surg. 1991 Oct;88(4):707-12. doi: 10.1097/00006534-199110000-00025.
We report the use of a two-layered free fascial flap consisting of temporoparietal and deep temporal fascia based on a single vascular pedicle, the superficial temporal artery and vein. The flap was used to reconstruct an extensive degloving injury of the dorsum of the hand, in which multiple intact extensor tendons lay fully exposed on all sides, with exposed bone beneath them. By sandwiching the tendons between the layers of vascularized fascia, gliding surfaces were provided, both superficial and deep to the exposed tendons. The single-stage reconstruction was completed with a split-thickness skin graft. The patient returned to heavy manual work within 12 weeks of injury. He obtained an excellent range of movement without the need for tenolysis.
