Faculty Collaboration Database

Salvage of ischemic digits using a lateral arm fascial flap. Plast Reconstr Surg 2001 Feb;107(2):398-407

Date

02/24/2001

Pubmed ID

11214055

DOI

10.1097/00006534-200102000-00015

Scopus ID

2-s2.0-0035144168 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

Four patients underwent microvascular transfer of a lateral arm fascial flap to salvage severely ischemic digits by means of induction of neovascularization. The cause of the digital ischemia was direct trauma (crush injury) in one patient and chronic embolic phenomena (proximal arterial occlusion) in three patients. None of the patients had responded to traditional therapy, including treatment with one or more of the following: anticoagulation, lytic therapy, oral vasodilators, digital sympathectomy, and vein bypass grafting. Each patient underwent noninvasive (Doppler ultrasound, digital pressures, digital temperatures, vascular refill) and invasive (angiogram) vascular assessment preoperatively. After microvascular transfer of the lateral arm fascial flap, all patients reported symptomatic relief, and objective improvements were documented by both noninvasive and invasive assessment criteria. One patient developed a seroma at the donor site; another experienced a late complication of thrombosis of the flap after his wound dehisced. A 6-month follow-up evaluation demonstrated neovascular collateralization and stable improvement without regression in the remaining patients. The authors present their clinical experience and propose a treatment algorithm for patients with chronic digital ischemia.

Author List

Summers AN, Matloub HS, Sanger JR

Authors

Hani S. Matloub MD Professor in the Plastic Surgery department at Medical College of Wisconsin
James R. Sanger MD Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Finger Injuries
Fingers
Follow-Up Studies
Humans
Ischemia
Male
Microsurgery
Middle Aged
Neovascularization, Physiologic
Postoperative Complications
Reoperation
Surgical Flaps