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Double bipedicled fasciocutaneous flap for reconstruction of an extensive upper extremity defect: A case report.

Martain PJ Loonen, Jessica Konopka

Reconstruction of extensive upper extremity defects with local or regional flaps is challenging. This case report presents a patient with an enlarging and easily bleeding irregular mass at the right distal dorsal-radial upper arm since months. A MRI revealed a 11 × 10 cm ill-defined lobulated soft tissue mass. An ultrasound guided core biopsy of the right arm showed histological features favor of a high grade malignancy, suspicious for Merkel Cell carcinoma. A complete excision of the lesion was performed followed by a double bipedicled fasciocutaneos flap. The double bipedicled flap is a reproducible flap for extensive upper arm defects and no former publications were found using this type of flap for upper extremity defects.