Application of Snuff-Box Flaps Based on Branches from the Radial Artery

Abstract

This paper reported experience with application of the snuff-box cutaneous flap in 10 patients with skin contracture in the hands. The sites with skin contracture were the first web sight in six, dorsal wrist in two, and palmar wrist in two. The flap was harvested centred by the snuff-box region with a width of 3 to 5 cm and length of 10 to 14 cm. This flap was based on the perforating branches from the radial artery in the snuff-box area. The pedicle of the flap was 4.2 mm in length. Venous drainage was through two concomitant veins of the perforating branch and the cephalic vein. Clinical application of this flap produced good results in nine cases and partial necrosis in one due to venous congention. This local cutaneous flap of the hand is recommended as a rotational pedicle flap to cover skin defects in the first web or the wrist regions. However, the flap may have disadvantages, such as failure of adequate venous return due to flap rotation or the necessity for a skin graft in the donor area when the flap is large.