Retrospective analysis of free temporoparietal fascial flap for defect reconstruction of the hand and the distal upper e
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HAND SURGERY
Retrospective analysis of free temporoparietal fascial flap for defect reconstruction of the hand and the distal upper extremity Wibke Müller‑Seubert1 · Raymund E. Horch1 · Vanessa Franziska Schmidt1,2 · Ingo Ludolph1 · Marweh Schmitz1 · Andreas Arkudas1 Received: 18 February 2020 / Accepted: 15 October 2020 © The Author(s) 2020
Abstract Introduction Soft tissue reconstruction of the hand and distal upper extremity is challenging to preserve the function of the hand as good as possible. Therefore, a thin flap has been shown to be useful. In this retrospective study, we aimed to show the use of the free temporoparietal fascial flap in soft tissue reconstruction of the hand and distal upper extremity. Methods We analysed the outcome of free temporoparietal fascial flaps that were used between the years 2007and 2016 at our institution. Major and minor complications, defect location and donor site morbidity were the main fields of interest. Results 14 patients received a free temporoparietal fascial flap for soft tissue reconstruction of the distal upper extremity. Minor complications were noted in three patients and major complications in two patients. Total flap necrosis occurred in one patient. Conclusion The free temporoparietal fascial flap is a useful tool in reconstructive surgery of the hand and the distal upper extremity with a low donor site morbidity and moderate rates of major and minor complications. Keywords Temporoparietal fascial flap · Hand · Upper extremity · Reconstruction
Introduction: The temporoparietal fascial flap (TPFF) was first described by Golovine in 1898 [1, 2]. To this day it is still a useful tool in reconstructive surgery [3]. It can be used as a pedicled flap to cover defects of the scalp, midface, mandible and oral cavity [4]. As a free flap it can cover defects whenever a very thin layer of tissue is needed. The long pedicle and the low donor site complications as well as the inconspicuous scar are the main advantages of this flap [1, 2]. These char‑ acteristics result in a good functional and aesthetic outcome especially when the defect is located at the hand. Further‑ more, harvesting the flap and exposing the recipient vessels
* Wibke Müller‑Seubert wibke.mueller‑seubert@uk‑erlangen.de 1
Department of Plastic and Hand Surgery of the FriedrichAlexander-University Erlangen-Nürnberg (FAU), Krankenhausstr. 12, 91054 Erlangen, Germany
Present Address: Department of Radiology, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
2
is possible simultaneously, if transplanting the TPFF to the upper extremity [5]. The anatomy of the TPFF has been described earlier [4, 6–9]. The temporalis fascia (TPF) is a thin, highly vascular‑ ized tissue that covers the temporalis muscle. It has a super‑ ficial and a deep layer, in between connective tissue and fat tissue. The TPF is mainly supplied by the superficial tempo‑ ral artery (STA). Recent studies have shown that 88% of the TPF get their blood supply from the STA, nine percent are supplied
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