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J Reconstr Microsurg 2003; 19(8): 555-560
DOI: 10.1055/s-2004-815642
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Dorsal Hand Coverage with Free Serratus Fascia Flap

Peter Fotopoulos1 , Per Holmer2 , Pernille Leicht2 , Jens Jorgen Elberg1
  • 1Department of Plastic Surgery and Burns
  • 2Department of Orthopedic Surgery, Hand Surgery Section, University Hospital Rigshospitalet, Copenhagen, Denmark
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Publication History

Publication Date:
14 January 2004 (online)

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ABSTRACT

In reconstructing a defect on the dorsum of the hand, with the extensor tendons exposed or even missing, functional, as well as cosmetic, goals are of major importance. The authors present three cases of extensor tendon reconstruction, combined with soft-tissue reconstruction, with the free serratus fascia flap, the connective tissue over the serratus muscle, for dorsal hand coverage. The flap consists of thin and well-vascularized pliable tissue, with gliding properties excellent for covering exposed tendons. It is based on the branches of the thoracodorsal artery, which are raised in the flap, leaving the long thoracic nerve intact on the serratus muscle. Coverage of the flap with split-thickness skin graft is done immediately. The free serratus fascia flap is an ideal flap for dorsal hand coverage when the extensor tendons are exposed, especially because of low donor-site morbidity.

KEYWORDS

Free flap - gliding tissue - serratus fascia - hand - thoracodorsal artery

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