Reconstruction of Hand and Upper Extremities Defects by Thin Random Pedicle Abdominal Flaps, Still a Valid Option in Developing Countries: A Cross Sectional Study
Reconstruction of Hand and Upper Extremities Defects by Thin Random Pedicle Abdominal Flaps, Still a Valid Option in Developing Countries: A Cross Sectional Study
Traumatic defects of the soft tissues of the hand and upper extremities are common and may be
 challenging to the reconstructive surgeon. Several reconstructive procedures have been
 described to manage these defects, including local, regional, distant, and free flaps. The
 aim of this study is to report the techniques, outcomes, and complications of pedicle
 abdominal flaps in reconstructing hand and upper extremity defects. 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. Data was collected and analyzed,
 variables studied included; patient age and sex, etiology and size of the defect,
 complications, outcomes, and the need for further revision procedures. Potential factors
 affecting flap survival were examined using appropriate statistical analysis.
Traumatic soft tissue defects of the hand and upper extremity are common and may be
 challenging to the reconstructive surgeon, especially when they are severe and associated
 with exposed vital structures such as tendons, nerves, bones, and joints. Although these
 defects are rarely lethal; they are invariably resource demanding, and a source of
 significant long-term disability. Several reconstructive procedures have been described to
 cover hand and upper extremities soft tissue defects, including local, regional, distant, and
 free flaps. Traditionally, pedicle abdominal flaps, whether axial or randomly based, have
 been considered the standard for successful upper limb reconstruction.

 With the introduction of microsurgery in the seventies of the last century, microsurgical
 free tissue transfers have become the gold standard for upper extremities functional
 reconstruction. Free flaps and other microsurgical techniques have been used to achieve
 early, functional, custom-tailored reconstructive solutions for upper limbs injuries.
 However, despite the superiority of free flaps, this option may not be always accessible
 especially in developing countries, owing to the high cost and technical demands. Moreover,
 they may be contraindicated in certain circumstances. In these situations, pedicle abdominal
 flaps may once again come into the light as an alternative option for safe and effective
 upper extremities reconstruction.

 At Jordan University Hospital, with limited microsurgical facilities, the investigators have
 been using random pedicle abdominal flaps in patients with different traumatic hand and upper
 extremities defects. The aim of this retrospective study is to report the investigator's
 experience in using this technique, in regards to the indications, complications, outcomes,
 and evaluating factors affecting flap survival rate.
Inclusion Criteria:

 -  different traumatic defects in the hand and upper extremities who underwent
 reconstruction by random pedicle abdominal flaps

 Exclusion Criteria:

 -  Patients with incomplete data about the patient and the surgery