The ultra thin and sensitive alt flap for hand reconstruction. Preliminary report

The primary thinning of the ALT flap has been postulated in order to achieve the actual concept in hand reconstruction: 1) function, 2) allows associated reconstructions and 3) aesthetic result. We propose the ALT ultra thin innervated flap to provide protection sensibility. Methods: From March'09 to January'11, 6 patients with hand defects due to crushing injuries and burn contractures were reconstructed with ALT thin sensate flap. We recorded size and thickness of the flap, associated reconstructions, secondary procedures, sensibility, and donor site closure. Results: Flaps had an average size of 11.6 x 9 cm corresponding to 104.4 cm2 and 3.5 mm thickness. Used on dorsum, palmar and volar digital. No skin necrosis reported. 100% recovered sensibility by 2 point discrimination and protection sensibility. Conclusion: We propose it in hand coverage because it provides stable coverage, protection sensibility; allow secondary reconstructions and good aesthetic results.