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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(05): 663-667
DOI: 10.1055/s-0042-1756344
Hand/Peripheral Nerve: Case Report

Use of Heparin Cream for Venous Congestion in the Extended Reverse Metacarpal Artery Flap: A Case Report

Burak Erguün Tatar 
1   Department of Plastic Surgery, University of Health Sciences, Bagcılar Training and Research Hospital, Istanbul, Turkey
,
Fahri Sabancıoğullarından 
1   Department of Plastic Surgery, University of Health Sciences, Bagcılar Training and Research Hospital, Istanbul, Turkey
,
Caner Gelbal 
1   Department of Plastic Surgery, University of Health Sciences, Bagcılar Training and Research Hospital, Istanbul, Turkey
,
Mehmet Bozkurt 
1   Department of Plastic Surgery, University of Health Sciences, Bagcılar Training and Research Hospital, Istanbul, Turkey
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Abstract

Finger dorsum defects are a challenging situation. Many reconstruction methods are used in these defects. Extended reverse dorsal metacarpal artery (RDMA) flap is used in dorsal finger reconstruction. Venous congestion in this flap is most important cause of flap failure. In this case, we presented a case in which we used heparin cream due to development of venous congestion in our patient who underwent an extended RDMA flap. A 24-year-old female patient presented to the emergency department with a defect of dorsal of left-hand fourth finger. Defect was covered with an extended RDMA flap. On postoperative first day, venous congestion was observed, and heparin cream was applied three times a day on flap. The signs of venous congestion were regressed. Tissue healed as a result of superficial epidermolysis and skin grafting. No functional limitation was observed in sixth-month postoperative control. Venous congestion is the most important cause of flap failure of extended RDMA flaps. Generally, subcutaneous heparin administration and leech therapy are used. In our case, heparin was applied as a cream instead of subcutaneously, and flap healing was observed as a result of superficial epidermolysis. Heparin cream application can also be used as a treatment option in flaps with venous congestion.

Keywords

heparin cream - finger defects - flap - microsurgery

Authors' Contributions

M.B. was involved in conceptualization. B.E.T. contributed to data curation. F.S. did formal analysis. B.E.T. was involved in project administration and methodology. C.G. contributed to visualization. B.E.T. and C.G. wrote the original draft. B.E.T. reviewed and edited the manuscript. All authors were involved in approval of final manuscript.


Ethical Apprpoval

We received the informed consent form from the patients for this study.




Publication History

Received: 14 January 2022

Accepted: 12 April 2022

Article published online:
23 September 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. 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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