Sahakyan A. B., Yagdjyan G. V.
Centre of Plastic and Reconstructive Surgery & Microsurgery,
Yerevan, Armenia
Despite of fast progress in plastic and reconstructive surgery, the plasty of extensive deep defects of the extremity tissues still remains to be an actual problem. During last years the reports about the use of flaps, located in vascular area of a dorsal branch of the ulnar artery (DUA), have appeared. Flap on a dorsal branch of the ulnar artery (DUF) have offered in 1985 by Becker & Gilbert, presenting 100 dissections, they have described the angioarchitecture of flap, its maximum sizes and 8 clinical cases of it application as the fascial insular flap. In literature there are reports about usage of insular, cutaneofascial flaps, supplied with blood both descending and ascending twig of medial cutaneous branch of DUA. The descending branch's flaps have received an own name- paramethocarpal. The given message is dedicated to performance of possibilities of a new source of donor tissues and is based on experience of its usage in 6 patients. The accumulated experience testifies that the donor zone located in the pool of DUA of the forearm vascular cord is the available source of tissue sites, different in form, sizes and structure. It opens new possibilities in plastic surgery, especially at reconstructive operations on a hand. The possibility of inclusion in contain of flap the dorsal branch of ulnar nerve as well as the cortical layer of ulna, allows to consider the given flap as a material for substitution of combined defects of a hand. Advantages of flaps on an ascending cutaneum branch of DUA is the simple method of flap mobilization, whereas the flap mobilization both on a descending cutaneum branch and osteal one differs by complicated technical performance as well as by the necessity of use of optical techniques. The use of flap does not result in cosmetic disorder in the forearm area and hand, that has an essential significance for women. In some subjects flap can have the hairy integument and in obese subjects - the significant thickness in the upper third of forearm.