The Superficial Circumflex Iliac Artery Perforator Flap for Devastating Hand Injuries in Obese Patients.

Abstract

INTRODUCTION:

Blast injuries to the hand, such as those from fireworks, are debilitating and life altering. Often, because of the nature of the injury, there is a need for soft tissue and skin coverage. However, in the increasingly obese American population, free flaps often are too bulky for functional hand coverage. In this study, we present a series of 7 patients who underwent the superficial circumflex iliac artery perforator (SCIP) flap for upper extremity reconstruction with improvement in cosmesis, including a primarily repaired donor site, as well as an overwhelmingly high return to work with minimal revision surgery necessary.

METHODS:

All patients who underwent a SCIP for hand injuries from a blast were included. Flaps were harvested based on previously described methods. A single attending surgeon performed all surgeries. All patients were followed for at least 6 months. Preoperative and postoperative characteristics were described.

RESULTS:

A total of 7 patients were included in this study. Ages ranged from 16 to 58 years and body mass index from 19 to 48 kg/m 2 . More than half of the patients had a body mass index greater than 30 kg/m 2 . All donor sites were primarily closed. Five patients returned to their preinjury work. Three patients had neurotized flaps with return of protective sensation. Three patients required revision surgery; all 3 had liposuction, and 1 had additional flap advancement surgery.

CONCLUSION:

The SCIP flap is a versatile flap that can be used in hand reconstruction in blast injuries with good functional outcome and improved cosmesis compared with other perforator flaps for the upper extremity.

• Authors: Nirbhay S Jain, Elijah Bingham, Mytien Goldberg
• Journal: Annals of plastic surgery (Ann Plast Surg) Vol. 91 Issue 4 Pg. 441-445 (10 01 2023) ISSN: 1536-3708 [Electronic] United States
• PMID: 37624863 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Topics

• Humans
• Adolescent
• Young Adult
• Adult
• Middle Aged
• Perforator Flap
• Blast Injuries
• Iliac Artery (surgery)
• Hand Injuries (surgery)
• Obesity