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Abstract
We present dorsal metacarpal artery flaps applied to 10 cases with the aim of reconstruction of the skin defects at the dorsum of the fingers and hand and whole thumb. The main aim was to obtain the skin coverage. Average age of our patients was 25,7, and the average follow up period was 25.7 months (2 years and 2 months). 6 out of 10 were island flaps. 3 axial flaps and one was reverse flow (distally based) flap. Seven were to cover the defects on thumb, cne was dorsum of the index finger, one was dorsum of the 3rd MP joint and the last one was dorsum of the wrist. Four cases were performed on emergency condition and six were as secondary procedure. Nine flaps proviced by 1st dorsal metacarpal artery. Four were performed with the sensory component. Average surface of the flaps were 14.1 cm2 and there were no flap necrosis. Authors speculate that within the limit of the flep surface, defects on the thumb palmary and dorsally as well as dorsally on fingers, hand and wrist, can be covered by the dorsal metacarpal artery fleps.
Özet
Başparmağın tümü, parmaklar ve el dorsal cildindeki defektlerin rekontrüksiyonu nedeniyle 1987-1993 yılları arasında 1O hastamıza uyguladıgımız dorsal metakarpal arter flepleri sunulmaktadır. Uygulamada temel amaç cilt örtüsünü sağlamaktı. Ortalama yaş 25.7, ortalama takip süresi 25.7 aydı (2 yıl 2 ay). Fleplerimizden 6 sı ada flepi, 3 ü aksial flep, biri ise ters akımlı (distal saplı) flepler idi. Bunlardan 7 si başparmaktaki, biri II. parmak dorsumundaki, biri III MP eklemdeki ve sonuncusu ise elbileği dorsumundaki defektlerin örtülmesi için kullanıldı. Dört olguya acil koşullarda, 6 olguya da sekonder olarak uygulandı. Dokuzu I. dorsal metakarpal arterin, biri II. dorsal metakarpal arterin beslediği flepler idi. Dördünde duyusal bileşeni ile birlikte alındı. Ortalama flep yüzeyi 14.1 cm2 olup, hiçbir flepte nekroz gözlenmedi. Yazarlar flep yüzeyinin izin verdiği ölçüde, dorsal metakarpal arter fleplerin, başparmağın palman, dorsali ve parmak, el ve elbileği dorsumundaki defektleri örtebileceğini düşünüyorlar.