V-Y advancement island flap based on the perforator of the anterior interosseous artery

Abstract

The limited sliding capacity of the V-Y advancement flaps has always been a problem. The mobility and reliability of the V-Y flap have been enhanced by raising it as an island flap based on perforators of the axial arteries in the extremities. The author elevated a new V-Y advancement island flap based on the dorsal perforator of the anterior interosseous artery on the dorsal aspect of the forearm for the dorsal defects of the wrist. This flap was used in the reconstruction of the dorsal defects of the wrist after tumor resection in two patients. Dissection was performed over the dorsal muscle fascia until the perforator was seen. The fascia was only incised all around the perforator. The donor sites were closed primarily in a V-Y fashion together with split thickness skin graft in patient 1 and only in a V-Y fashion in patient 2. The patients were followed-up from 13 to 15 months. All flaps survived completely. This flap is an alternative option for closure of medium to large defects on the dorsum of the wrist.