The management of arteriovenous malformations (AVMs) of the hand remains challenging. When radical excision results in large defects of both soft tissue and vessels, flow-through flap transfer is useful; however, flow-through flap options for hand and digit reconstructions are limited. Herein, we describe the use of a superficial circumflex iliac artery perforator (SCIP) flow-through flap after excision of an AVM of the hand. A 44-year-old female patient with an AVM of the hand required simultaneous reconstruction of soft tissue, vascular, and bone defects after radical excision of vascular lesions. A 6 × 15 cm SCIP flow-through flap was transferred, and flow-through vascular reconstruction was performed with flap vessels: the deep branch of the superficial circumflex iliac artery, superficial inferior epigastric artery, and superficial circumflex iliac vein. In addition, three bone holes in the proximal phalanx of the index finger were filled with iliac bone grafts. The postoperative course was uneventful, with good functional results 1 year after surgery. An SCIP flow-through flap is an option for reconstruction after excision of AVMs of the hand because of its advantages, including minimal donor-site morbidity, availability of multiple vessels suitable for anastomosis with hand vessels, and simultaneous availability of iliac bone grafts.
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Article Synopsis
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- Thirteen patients with severe injuries underwent surgery using the ALTP flap technique, with most showing successful limb and flap survival, although some experienced complications like limb shortening and necrosis.
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