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Sandwich Flap Reconstruction for a Degloving Hand Injury

Preprint Archives of Clinical Images & Videos. 2017;1(1):5
DOI: 10.24983/scitemed.paciv.2017.00008
Article Type: Image

Abstract

Keywords

    A 38-year-old male presented with degloved dominant right hand as the result of a crush injury (Panel A and B). The injury to the skin envelope was too severe to be considered for replantation. After initial debridement and washout, the resultant defect was assessed to be implausible for single flap closure. Immediate reconstruction was performed with a pedicled anterolateral thigh flap and a pedicled groin flap (sandwich style inset, hence, the sandwich flap, Panel D-F). Spare part surgery was also performed as skin grafts were needed and were taken from the degloved skin flap. The post-operative course was uneventful, however, multiple revision surgeries including flap divisions, interdigitation, tenolysis, capsulectomy, and debulking procedures, as well as free medial sural artery perforator flap for the first web space reconstruction were needed for functional reconstruction of the hand. The patient eventually achieved functional tripod pinch, enabling writing and executing basic housework for activities of daily living (Panel G-I).

    Editorial Information

    Publication History

    Received date: May 08, 2017
    Accepted date: May 08, 2017
    Published date: May 09, 2017

    Copyright

    © 2017 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY).

    Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Microsurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
    Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Microsurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
    Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Microsurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
    Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Microsurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
    Email: Tommynjchang@yahoo.com.tw