[Reconstruction of extensive soft-tissue defects at the upper extremities using the pre-expanded paraumbilical perforator flaps].

Objective: To explore the feasibility and technique of reconstruction of extensive soft-tissue defects at upper extremities using the pre-expanded paraumbilical perforator (PUP) flaps.

Methods: Pre-expanded PUP flap was used to reconstruct large soft-tissue defect at the upper extremity according to the size, shape, and location of the defect in a multiple-staged procedure.

Results: From Sept.2009 to Sept.2015,81 patients underwent defect reconstruction using the pre-expanded PUP flaps.93 preexpanded PUP flaps were used. Unilateral flap was used in 70 patients. Bilateral flaps were used to reconstruct the circumferential forearm defects in eight patients (16 flaps).Bilateral flaps were used to reconstruct bilateral forearm defects in three patients (6 flaps).The size of the flaps ranged from 8 cm ×6 cm to 40 cm × 15 cm. Small-sized distal flap necrosis occurred in five patients after division of the proximal pedicle of the flap. The patients were followed up for 1 to 5 years (average 3.5 years) with satisfactory functional and aesthetic outcomes. Dysfunction of the shoulder and elbow joints was not noticed postoperatively.

Conclusions: The pre-expanded paraumbilical perforator flap provides a valuable option for different defects reconstruction at the upper extremity.