Oğuz ÖZDEMİR, Erhan COŞKUNOL, Hüseyin S. YERCAN

Fillet flep ile el defektlerinin tedavisi

Amaç: Elde, travma ve epidermoid karsinom sağıltımı sırasında gelişen defektlerin kapatılmasında fillet flebin kullanımının değerlendirilmesi. Çalışma planı: Travma ve epidermoid karsinom ameliyatlarında gelişen defektlerin kapatılmasında fillet flep kullanılan yedi olgu (5 erkek, 2 kadın; ort. yaş 55; dağılım 9-78) değerlendirdi. Fillet flep, bir olguda ikinci parmaktan, iki olguda dördüncü parmaktan, dört olguda da beşinci parmaktan yararlanılarak hazırlandı. Flebin iyileşmesi ve defekt bölgesine olan uyumu incelendi. Digital sinirlerini koruyabildiğimiz iki olgu iki nokta ayrım testi ile flep bölgesinde oluşabilecek duyu kusuru açısından değerlendirildi. Ortalama izlem süresi beş yıl (dağılım 3- 7 yıl) idi. Sonuçlar: Hiçbir olguda flep bölgesinde nekroz izlenmedi. iki olgunun duyu muayenesinde tamamen normal bulgular elde edildi. Epidermoid karsinomlu iki olguda gelişen ülser, bir olguda daha sonra sorunsuz iyileşirken, diğerinde ülserin gelişimi yetersiz cerrahi rezeksiyona ve tümor nüksüne bağlandı. Çıkarımlar: Fillet flep kullanımı tek safhalı ve göreceli olarak kolay bir tekniktir. Serbest flep kullanıldığında gelişen donör saha morbiditesi fillet flepte yaşanmaz.

Anahtar Kelimeler:

Yumuşak doku yaralanmaları, Cerrahi flepler, El yaralanmaları, El parmakları, El parmağı yaralanmaları

Treatment of the hand defects with fillet flap

Objectives: To evaluate the use of fillet flaps in the coverage of digital soft tissue defects caused by hand trauma or resection of epidermoid carcinoma. Methods: We evaluated seven patients (5 males, 2 females; mean age 55 years; range 9 to 78 years) in whom the coverage of hand soft tissue defects caused by hand trauma or resection of epidermoid carcinoma was performed with the use of fillet flaps. Fillet flaps were prepared from the fifth, forth, and second fingers in four, two, and one patients, respectively. We evaluated the healing potential and adjustment of the flaps to the defect region. Static two-point discrimination test was performed in two patients whose digital nerves were preserved. The mean follow-up period was five years (range 3 to 7 years). Results: No signs of necrosis were encountered in the flap region. Two-point discrimination test was normal in two patients. Two patients with epidermoid carcinoma developed skin ulcers in the flap region. One patient achieved complete recovery. In the other patient, skin ulcers were attributed to insufficient tumor resection and recurrence. Conclusion: The use of fillet flaps in the reconstruction of hand defects is easy and allows immediate wound coverage without any significant morbidity to the donor site.

Keywords:

Soft Tissue Injuries, Surgical Flaps, Hand Injuries, Fingers, Finger Injuries,

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