ABSTRACT
Background: While contemplating any difficult soft tissue reconstruction, patient comfort and
compliance is of paramount importance. Reconstruction of the volar aspect of fingers
and hand by the ipsilateral pedicled flaps (groin flap, abdominal flaps) is demanding
as the flap inset is difficult for the surgeon and very uncomfortable for the patient.
This often leads to flap complications. For the comfort of the patient, better compliance
and ease of complete inset, we planned to manage soft tissue defects of the volar
aspect of fingers and hand by a new contralateral pedicled lumbo-umbilical flap. This
flap is based on the paraumbilical perforators of deep inferior epigastric artery.
Materials and Methods: The contralateral pedicled lumbo-umbilical flap was used in eight patients with high-tension
electrical burn injuries involving the volar aspect of fingers and hand. The patients
were closely observed for first 6 weeks for any flap or donor site complications and
then followed monthly to assess donor and recipient site characteristics for 6 months
to 2 years. Results and Conclusion: Large flaps up to 8 cm × 16 cm were raised. All but one flaps survived completely.
All patients were mobilised within 48 h and five were discharged in less than a week
after initial inset. The flap is reliable, easy to harvest and easy to inset on the
volar aspect of fingers. The arm is positioned in a very comfortable position. The
main disadvantage, however, is a conspicuous abdominal scar.
KEY WORDS
Finger defect - groin flap - hand defect - high-tension electric burn - lumbo-umbilical
flap - paraumbilical perforators
