Superthin Abdominal Wall Glove-Like Flap Combined With Vacuum-Assisted Closure Therapy for Soft Tissue Reconstruction in Severely Burned Hands or With Infection

Ann Plast Surg. 2015 Dec;75(6):603-6. doi: 10.1097/SAP.0000000000000602.

Abstract

Severe burn and infection to hands always involves the deep structures, such as tendons, joints, and bones. These wounds cannot be closed immediately and therefore creates a high risk for complication. We presented 9 cases with deep dermal burns to the dorsal of the hand (6 electrical burns and 3 thermal crush injuries) with wound infections in 2 cases. The vacuum-assisted closure system was used continuously until the flap reconstruction was performed. A random pattern and superthin abdominal wall skin flap-like glove was designed. The flap was transferred to the defected portion of the dorsum of the hand and resected from the abdominal wall about 3 weeks later. The flaps in 8 of the patients treated by this technique survived completely and partial necrosis of the distal flap occurred in 1 patient. The defect resolved after operative treatment and the function of the hands and fingers were successfully salvaged. All patients resulted in having a satisfactory aesthetic outcome with no or minor discomfort at the abdominal donor area. Integration of the vacuum-assisted closure system and the superthin abdominal wall glove-like flap reconstruction appeared to be successful and should be considered in patients with severely burned hands.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Wall / surgery*
  • Adult
  • Burns / complications
  • Burns / surgery*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Hand Injuries / complications
  • Hand Injuries / surgery*
  • Humans
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy*
  • Plastic Surgery Procedures / methods*
  • Pseudomonas Infections / diagnosis
  • Pseudomonas Infections / etiology
  • Pseudomonas Infections / surgery
  • Pseudomonas aeruginosa / isolation & purification
  • Surgical Flaps*
  • Treatment Outcome
  • Wound Infection / diagnosis
  • Wound Infection / etiology
  • Wound Infection / surgery*