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A Free Superficial Palmar Branch Of the Radial Artery (SPBRA) Flap for Finger Soft-tissue Reconstruction
Shimpei Ono, MD, PhD1, Hiroyuki Ohi, MD2, Rei Ogawa, MD, PhD, FACS1.
1Nippon Medical School, Tokyo, Japan, 2Seirei Hamamatsu General Hospital, Shizuoka, Japan.

PURPOSE:
Functional and aesthetic reconstruction for digital soft-tissue defects can be challenging for plastic surgeons because there may not be enough remaining skin to harvest local flaps around the defect. The aim of this study is to present a clinical case series of free superficial palmar branch of the radial artery (SPBRA) flaps for soft-tissue reconstruction of the finger.
METHODS:
Free SPBRA flaps were harvested for 11 fingers of ten patients. The injured fingers included five index, three long, two ring, and one small finger. All the flaps were vascularized by the SPBRA, usually bifurcates from the radial artery (Fig). There were two types of venous drainage systems in the flaps: the concomitant vein of the SPBRA and the subcutaneous vein.
RESULTS:
All the flaps survived completely, except for two cases of partial necrosis. All the donor sites were closed primarily. Most of the fingers involved achieved a full range of motion and showed a good contour and color/texture match. Two-point spatial sensory discrimination was recorded for all patients and adequate protective sensation was attained.
CONCLUSION:
The SPBRA flap is large enough to cover large finger defects without sacrificing the major vessels. Providing a thin, pliable, hairless, and well-vascularized skin cover with a perfect color match, the SPBRA flap seems to be a useful solution to overcome the skin coverage dilemma in patients with finger defects.


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