Outcomes of Loco-Regional Perforator Flaps in Upper Limb Soft Tissue Defect Management

Background: The reconstruction of soft tissue defects in the upper limb is a complex yet frequent challenge. Local flap solutions have proven dependable and standard for addressing significant soft-tissue abnormalities in the proximal and distal upper limb.

Objective: To determine the outcome of loco-regional perforator flaps in terms of post-operative flap survival in soft tissue defects of upper limb.

Methodology: This descriptive case study was carried out over a period of twelve months (January 2020 to December 2020) at the department of Plastic and reconstructive surgery, Dow University of Health Sciences, Civil Hospital, Karachi. Patients of both genders between 18-60 years of age, presenting with upper extremity defects of up to 8 cm length and 4 cm width, with exposed underlying structures thus requiring soft tissue reconstruction, were included. Pedicled, locoregional perforator flap reconstruction was done in all cases. Patients were observed for complications daily until the 7^th post-operative day.

Results: 30 patients were included in this study. Mean age was 36.43 years. A male preponderance was observed [21(70%) males and 9(30%) females]. Types of flap shows that radial artery flaps were done in 7 (23.30%), ulnar artery flaps in 11 (36.70%), posterior interosseous artery flaps in 4 (13.30%), lateral arm flaps in 6 (20%) and medial arm flaps in 2 (6.70%) patients. Flap survival was found in 27 (90%) patients.

Conclusion: Perforator flaps are an important tool in small to medium soft tissue defects requiring flap coverage.

Keywords: perforator flap, soft tissue defects, upper limb reconstruction

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