Reconstruction of Upper Extremity Defects by Random Pedicle Abdominal Flaps: Is It Still a Valid Option?

Background: Traumatic soft tissue defects of the hand and upper extremities are common and may be challenging to the reconstructive surgeon. Several reconstructive procedures such as use of local, regional, distant, and free flaps have been described. This study aimed to report the techniques, outcomes, and complications of pedicle abdominal flaps in reconstructing hand and upper extremity defects. Methods: In this retrospective study, we included patients with different traumatic defects in the hand and upper extremities who underwent reconstruction by random pedicle abdominal flaps between 2002 and 2017 at Jordan University Hospital, Jordan. Data were collected and analyzed, and the variables studied included patient age and sex, etiology and size of the defect, complications, outcomes, and the need for further revision procedures. Appropriate statistical analysis was used to examine the potential factors affecting flap survival. Results: We included a total of 34 patients with a mean age of 22.2 years, ranging from 1 to 54 years. Finger degloving was seen in approximately half of the patients. Flap survival rate was 85.3%. A small area of defect was the only risk factor that significantly affected the flap failure rate. Conclusions: Thin pedicle abdominal flaps are a valid, affordable, and safe option in upper extremity traumatic defects, especially in situations where microsurgical techniques are unavailable or contraindicated. Extra care should be taken when the defect surface area is small.