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Online ISSN 1827-1707
Galli S., Vigasio A., Simonini G., Pazzaglia U. E.
Background. Personal surgical experience in the use of the dorsal ulnar flap of Becker in hand surgery is presented.
Methods. A retrospective study with an average follow-up of 21,5 months is made. From 1993 till today we used this flap, whose pedicle derives from the dorsal ascending branch of the ulnar artery, in 12 patients. We covered an hypothenar defect in 2 cases, a palmar defect in 1 case, a dorsal first ray defect in 3 cases, restored a first web space in 2 cases and used a fascial-fat flap as a salvage procedure in 4 recurrent carpal tunnel syndrome. The surgical technique to prepare this flap are different: peninsular flap, fascial-fat flap, free flap, island flap. We sometimes modified the last one, exposing the vascular pedicle over the skin; it permits to cover a little more distal skin defects, without the risk of flap necrosis due to excessive pedicle tension or compression. In every patient the healing modality and early or late complications of the flap have been evaluated.
Results. In 7 of the 8 cases in which the flap was used to cover a skin defect we had an excellent result. In the 4 cases in which a fascial-fat flap was used as a salvage procedure for recurrent carpal tunnel syndrome we always had a clinical improvement.
Conclusions. The great advantage of this flap is to preserve an important forearm arterial axis; it is easy to do and gives an excellent skin coverage. With our modification it is possible to slightly extend the original indications.