Ultra-thin abdominal flap for resurfacing of upper limb defects, an old technique, is it still valid?

Background : The reconstruction of soft tissue defects of the hand, wrist, and forearm with exposed tendons, joints, bones, and neurovascular bundles represents a great challenge for plastic surgeons. Such defects require early and effective quality coverage to protect the underlying vital structures, preserve hand functions, and allow for early rehabilitation. This study aimed to evaluate the versatility of ultra-thin abdominal flap for the coverage of hand and forearm soft tissue loss with no or minimal morbidity or further debulking procedures. Methods: From January 2013 to April 2019, all patients in whom ultra-thin abdominal flaps were used to resurface soft tissue defects of the hand and forearm were retrospectively reviewed and included in this study. Patient satisfaction was also investigated and categorized into three groups: satisfaction with reconstructed defects, flap donor sites, and the graft donor site. Results: Thirty flaps were used to resurface 30 upper limb defects with minimal complications and good esthetic outcome with no need for further flap debulking. Twenty patients were very satisfied with the defect coverage, nine were satisfied, and one patient was not satisfied. Regarding the flap donor site, 11 patients were very satisfied, 17 were satisfied, while two patients were not satisfied. Conclusions: Soft tissue defects of the upper limb can be reconstructed effectively with the ultra-thin abdominal flap resulting in minor or no complications. This flap gives good results with minimal donor site morbidity if it is well designed and meticulously dissected. Level of evidence: Level IV, Therapeutic study [ABSTRACT FROM AUTHOR]