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DOI: 10.1055/s-0041-1729954
Epimysial Transposition Flap: A Novel Technique for Coverage of Exposed Tendon after Tissue Transfer
Abstract
Background The radial forearm flap (RFF) is a versatile flap that can be used for soft-tissue coverage or as a source of vascularized bone during reconstruction. A problem that can arise after RFF harvest is tendon exposure in the donor site, which may lead to tendon injury and restriction of the hand and wrist’s range of motion. Many different methods for providing adequate tendon coverage in the donor site after RFF harvest have been reported. We present a novel technique for coverage of exposed tendon in the volar forearm with an epimysial transposition flap and a split-thickness skin graft (STSG).
Methods Retrospective review of two cases: one salvage case with exposed tendon after harvesting an RFF and another with exposed volar forearm tendon after traumatic injuries. Variables of interest were post-operative STSG integration and hand/wrist range of motion.
Results Both cases demonstrated 100% graft take at 5-week follow-up. No decrease in hand/wrist range of motion in the patient that could undergo testing.
Conclusion We introduce two cases for coverage of exposed flexor tendon in the volar forearm with an epimysial transposition flap. This can be used as a salvage operation for coverage of exposed tendon or as an acute method of tendon coverage prior to skin grafting. In both cases, the skin graft had excellent incorporation.
Publication History
Received: 17 July 2020
Accepted: 27 January 2021
Article published online:
29 June 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Simman R, Hermans MHE. Managing wounds with exposed bone and tendon with an esterified hyaluronic acid matrix (eHAM): a literature review and personal experience. J Am Coll Clin Wound Spec 2018; 9 (1–3): 1-9
- 2 Trumble TE. Principles of Hand Surgery and Therapy. Philadelphia, PA: W.B. Saunders; 2000
- 3 Pabst AM, Werkmeister R, Steegmann J, Hölzle F, Bartella A. Is there an ideal way to close the donor site of radial forearm free flaps?. Br J Oral Maxillofac Surg 2018; 56 (06) 444-452
- 4 Nehrer-Tairych GV, Millesi W, Schuhfried O, Rath T. A comparison of the donor-site morbidity after using the prelaminated fasciomucosal flap and the fasciocutaneous radial forearm flap for intraoral reconstruction. Br J Plast Surg 2002; 55 (03) 198-202
- 5 Bucholz RW, Heckman JD, Court-Brown CM, Rockwood CA, Green DP. eds. Rockwood and Green's Fractures in Adults. Vol. 1. Philadelphia, PA: Lippincott, Williams & Wilkins; 2006
- 6 Davis-Zeek D. Pearls for practice: managing wounds with exposed tendon. Wound Management and Prevention 2009;55(10):
- 7 Etzkorn JR, Sobanko JF, Shin TM, Miller CJ. Repair of a large dorsal hand defect with exposed tendons. Dermatol Surg 2018; 44 (12) 1583-1586
- 8 Skoner JM, Bascom DA, Cohen JI, Andersen PE, Wax MK. Short-term functional donor site morbidity after radial forearm fasciocutaneous free flap harvest. Laryngoscope 2003; 113 (12) 2091-2094
- 9 Jaquet Y, Enepekides DJ, Torgerson C, Higgins KM. Radial forearm free flap donor site morbidity: ulnar-based transposition flap vs split-thickness skin graft. Arch Otolaryngol Head Neck Surg 2012; 138 (01) 38-43