RSS-Feed abonnieren
DOI: 10.1055/s-0038-1630146
Volar Resurfacing of the Thumb with a Superficial Circumflex Iliac Artery Perforator Flap after Hydrofluoric Acid Burn
Funding None.Publikationsverlauf
Received: 26. November 2017
Accepted after revision: 02. Januar 2018
Publikationsdatum:
05. April 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00031417/201803/lookinside/thumbnails/10-1055-s-0038-1630146_00011-1.jpg)
Abstract
A right-hand-dominant 55-year-old male automotive mechanic presented 24 hours following a hydrofluoric acid burn to the volar left thumb. Despite the severity of soft tissue injury, the neurovascular bundles were intact. Although a free toe-pulp flap is often described to cover volar digit defects, the resultant 6- × 4-cm full-thickness injury of the thumb was too large to be adequately covered by a toe-pulp flap or other commonly used local flaps from the ipsilateral hand. The authors used a superficial circumflex iliac artery perforator (SCIP) flap to reconstruct the volar surface of the thumb from the tip to the metacarpophalangeal joint. They used an arterial anastomosis with the princeps pollicis artery so that the anastomosis was well outside the zone of injury. The patient recovered from the procedure without event and was discharged home on postoperative day 5. At his 2-week postoperative visit, protective sensation with diminished light touch was intact. The authors conclude that the SCIP flap is a technically challenging but versatile, thin flap with minimal donor site morbidity that can be used to resurface the volar aspect of the thumb. The SCIP flap is a valuable resource for the hand surgeon confronted with larger soft tissue defects of the hand.
-
References
- 1 Dowbak G, Rose K, Rohrich RJ. A biochemical and histologic rationale for the treatment of hydrofluoric acid burns with calcium gluconate. J Burn Care Rehabil 1994; 15 (04) 323-327
- 2 McKee D, Thoma A, Bailey K, Fish J. A review of hydrofluoric acid burn management. Plast Surg (Oakv) 2014; 22 (02) 95-98
- 3 Han HH, Kwon BY, Jung SN, Moon SH. Importance of initial management and surgical treatment after hydrofluoric acid burn of the finger. Burns 2017; 43 (01) e1-e6
- 4 Zhang Y, Zhang J, Wang X. Treatment of hydrofluoric acid burns of the fingers. J Plast Reconstr Aesthet Surg 2016; 69 (03) 436-437
- 5 Kim DY, Kim DW, Dhong ES. Early surgical treatment by free flap reconstruction of hydrofluoric acid burn injury. J Plast Reconstr Aesthet Surg 2015; 68 (10) 1477-1478
- 6 Goh TLH, Park SW, Cho JY, Choi JW, Hong JP. The search for the ideal thin skin flap: superficial circumflex iliac artery perforator flap—a review of 210 cases. Plast Reconstr Surg 2015; 135 (02) 592-601
- 7 Delikonstantinou IP, Gravvanis AI, Dimitriou V, Zogogiannis I, Douma A, Tsoutsos DA. Foucher first dorsal metacarpal artery flap versus littler heterodigital neurovascular flap in resurfacing thumb pulp loss defects. Ann Plast Surg 2011; 67 (02) 119-122
- 8 Germann G, Sauerbier M, Rudolf KD, Hrabowski M. Management of thumb tip injuries. J Hand Surg Am 2015; 40 (03) 614-622
- 9 Daniel RK, Taylor GI. Distant transfer of an island flap by microvascular anastomoses. A clinical technique. Plast Reconstr Surg 1973; 52 (02) 111-117
- 10 Koshima I, Nanba Y, Tsutsui T. et al. Superficial circumflex iliac artery perforator flap for reconstruction of limb defects. Plast Reconstr Surg 2004; 113 (01) 233-240
- 11 Iida T, Mihara M, Yoshimatsu H, Narushima M, Koshima I. Versatility of the superficial circumflex iliac artery perforator flap in head and neck reconstruction. Ann Plast Surg 2014; 72 (03) 332-336
- 12 Tashiro K, Harima M, Kato M. et al. Preoperative color Doppler ultrasound assessment in planning of SCIP flaps. J Plast Reconstr Aesthet Surg 2015; 68 (07) 979-983
- 13 Suh HS, Jeong HH, Choi DH, Hong JP. Study of the medial superficial perforator of the superficial circumflex iliac artery perforator flap using computed tomographic angiography and surgical anatomy in 142 patients. Plast Reconstr Surg 2017; 139 (03) 738-748