Numan ATILGAN, Tahsin Sami ÇOLAK, Numan DUMAN, Mehmet Rauf KOÇ

Başparmak Pulpa Defektlerinin Foucher Flebi İle Onarımı: 14 Vakanın Değerlendirmesi

Giriş: Başparmak pulpası el yaralanmalarının sık görüldüğü bir bölgedir ve yaralanma sonrası yapılan rekonstrüksiyonla kazanılan duyu el fonksiyonu için oldukça önemlidir. Çalışmamız başparmak pulpa defektinin rekonstrüksiyonunda kullanılan birinci dorsal metakarpal arter ada flebi olan Foucher’s flebinin kullanımı ve sonuçlarını tartışmak için yapıldı. Yöntem: Çalışmamıza 2019 – 2021 yılları arasında hastanemize başvuran 14 başparmak pulp defektli 14 hasta dahil edildi. Hastalarımızın 12’si erkek, 2’si kadın, yaş ortalamaları ise 40,5±14,43 idi. 11 hastaya elektif cerrahi, 3 hastamıza da acil cerrahi uygulandı. Hastalarımız ameliyat sonrasındaki 1. hafta, 1. ay, 3. ay 6. ay ve 12. ay olarak takip edildi. Sonuç: Ortalama flep boyutu 2,57 x 2,07 cm idi. Hastaların ortalama iki nokta ayrım duyarlılığı (s2-PD) 8,9 mm olarak ölçüldü ve bu sonuç gayet tatmin ediciydi. Bir hastamızda marjinal nekroz, bir hastamızda epidermoliz ve bir hastamızda venöz konjesyon gözlemledik fakat uyguladığımız fleplerin hiçbirinde flep kaybı yaşamadık. Tartışma: Foucher’s flebi başparmak pulp defekti olan hastalarda dokunma hissini sağlayabilen başarılı bir yumuşak doku rekonstrüksiyon tekniğidir. Donör sahada minimal morbidite oluşturarak pulp defekti dokunma hissi elde edilerek rekonstrükte edilmektedir. Çalışmamızda da minimum komplikasyon ve güvenilir bir rekonstrüksiyon tekniği olduğunu göstermiş olduk.

Anahtar Kelimeler:

Foucher’s flep, Başparmak pulp defekti, Dorsal metakarpal arter, Ada flebi

Foucher’s Flap For Reconstruction of Thumb Pulp Defects: Evaluation of 14 Cases

Background: Thumb pulp is a common site for hand injuries and the sensory function gained with its reconstruction is very important for hand function. We aimed the focusing in Foucher’s flap of the first dorsal metacarpal artery for coverage of thumb pulp defects. Methods: Our study was done over a period of two years, between 2019 and 2021 and involved 14 consecutive cases of thumb pulp defects treated in our institution. The patients included 12 males and 2 female, mean age of 40,5±14,43 years. Three elective and eleven emergency cases were operated in the study. We observed the patients for a period as following first week, 1 st. Month, 3. Month, 6 and 12 month. Results: The mean used flap was 2,57x2,07 cm. All the patients had good fine touch and the mean two-point discrimination (s2-PD) was 8,9 mm, which was satisfactory. No flap loss occurred in any patient; one patient distal margin necrosis, one patient epidermolysis and one patient venous congestion were observed. Conclusion: Foucher’s flap for thumb pulp defects is successful flap tecnique for sensation reconstruction. It replaces the soft tissue loss at the thumb pulp with minimal donor site morbidity and with good return of thumb pulp sensation. Our experience showed that Foucher’s flap is reliable option and has minimal complications.

Keywords:

Foucher’s flap, thumb pulp defect, dorsal metacarpal artery, island flap,

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