Oblique Pedicled Paraumbilical Perforator–Based Flap for Reconstruction of Complex Proximal and Mid-Forearm Defects: A Report of Two Cases

Reconstruction of complex proximal and mid-forearm wounds can be challenging. Free tissue transfer might not be feasible in certain patients or at institutions lacking microsurgical expertise and equipment. Traditional pedicled flaps are either insufficient in length to reach more proximal forearm defects or are used sparingly due to donor site complications and extremity stiffness. We present a novel technique to reconstruct forearm defects using the oblique pedicled paraumbilical perforator (PUP) based flap. This flap is simple to harvest, has low donor site morbidity, and allows elbow and shoulder range of motion during the interval between flap transfer and pedicle division.

Key Words: Paraumbilical, pedicled flap, perforator flap, proximal forearm, upper extremity reconstruction