The Number of Perforators Included in Reversed Flow Posterior Interosseous Artery Flap: Does It Affect the Incidence of Venous Congestion?

BACKGROUND The purpose of this study is to decrease the incidence of venous congestion occurring in the reversed flow posterior interosseous artery flap used for coverage of hand defects. METHODS This may be achieved by studying the incidence of venous congestion in flaps including only 1 perforator and comparing the results with others including more than 1 perforator both in small and large sized flaps. RESULTS This study showed that inclusion of only 1 perforator in the flap decreased the incidence of venous congestion with complete flap loss in flaps to 5%. Also, it decreased the incidence of venous congestion with partial flap loss in flaps to 10%. CONCLUSIONS The small sized reversed flow posterior interosseous artery flap should be less than 40 cm2 and should include only 1 perforator to decrease the incidence of venous congestion with partial and complete loss of the flap. The level of evidence for this study is the type II prospective comparative study.