Thursday, August 13, 2009

Kite Flap






Hand Flaps & Micro Surgery

Kite Flap
Based on the first dorsal metacarpal artery axial pattern flap, which can be sensate if we take the accompanying nerve – to cover a defect at the tip of the thumb.



Uses

Can be pedicled or free

- To cover defects at the dorsum of the thumb
- At the Ulnar aspect of the lateral thumb
- Or also rarely at the tip of the thumb
- Dorsal hand defects

Method

1) Line and draw ur surgery
a) Draw a line on the 1st MC and another on the 2nd MC
b) The branch artery from the radial is positioned in the center of between the two metacarpals
c) FDMA runs parallel to the 2nd MC

2) Start the incision on your lines of drawing

3) No need to dissect the fascia looking for the FDMA or even to follow it back o the radial artery as it can damage up your flap ( one glance is enough ) have a faith in its presence.
4) There will be another branch coming out at the level of the 1st Metacarpal head which you will need to ligate or burn.

5) Cut the flap as if cross finger flap

6) Raise the flap slowly above the paratenon of the extensor tendons
7) There you will see the nerve supply almost at the centre of the flap – take it with u
8) Suture the flap over the debrided and clean defect
9) Close the primary wound and cover the flap site with split thickness skin graft.
You R Done
Dr. Fawaz N. AlBalushi
Hand- Plastic & Micro Reconstructive Surgery

3 comments:

  1. I forgot one thing
    You can Use doppler to locate the vessel insted of destroying the surrounding tissue.

    take care

    ReplyDelete
    Replies
    1. Hi Doctor need your number to take appointment for face operation

      Delete