Reconstruction of the soft-tissue defect of the elbow and upper arm using the radial collateral artery perforator propeller flap
10.3760/cma.j.cn114453-20200328-00184
- VernacularTitle:桡侧副动脉穿支螺旋桨皮瓣修复肘部及上臂皮肤软组织缺损
- Author:
Shanshan LI
1
;
Shan ZHU
;
Mengqing ZANG
;
Bo CHEN
;
Tinglu HAN
;
Tingjun XIE
;
Shuai YUE
;
Danying WANG
;
Yuanbo LIU
Author Information
1. 中国医学科学院北京协和医学院整形外科医院瘢痕综合治疗中心 100144
- Keywords:
Perforator flap;
Reconstructive surgical procedures;
Elbow, arm;
Propeller flaps
- From:
Chinese Journal of Plastic Surgery
2020;36(9):984-989
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the indications and technical tips of defect reconstruction in the elbow and upper arm using the radial collateral artery perforator (RCAP) propeller flap.Methods:From October 2016 to December 2019, 6 patients underwent defect reconstruction using the RCAP propeller flaps. All patients were female, aged from 5 to 66 years, with an average of 31 years. All of the defects were repaired with radial collateral artery perforator propeller flap. Before the surgery, the RCAP was thoroughly explored using the hand-held ultrasound Doppler and marked on the skin. According to the size, shape and location of the defect, a RCAP propeller flap was elevated based on the chosen RCAP, rotated in a certain degree with the perforating point as the rotation point. The large paddle was used to repair the defect of the upper extremity, and the small paddle was used to assist in closing the donor site. The donor sites were sutured directly or repaired with free skin graft. Capillary filling test or indocyanine green SPY fluorescence imaging system was used to evaluate the blood supply of the flap immediately. The effect was observed.Results:The defect size ranged from 6.0 cm × 3.0 cm to 10.0 cm × 7.0 cm. The flap size ranged from 6.0 cm × 3.5 cm to 20.0 cm × 8.0 cm. All perforators were septocutaneous perforators. The pedicle of the pedicle ranged from 2.5 cm to 5.0 cm and the mean length was 3.6 cm. The flaps were rotated 180° in 5 patients, and 150° in one patient. The donor sites were sutured directly in 5 patients and repaired with free skin graft in one patient. Five flaps survived completely without any major complications. Wound infection occurred in one flap, which healed after debridement. All donor sites were closed primarily, except one which was covered by free skin grafting. All patients were followed up for 3 months to 3 years and the average follow-up time was 2.4 years. The appearance and texture of the flap were good, and the motion of elbow joint was normal. All patients were satisfied with the functional and aesthetic outcomes of the upper extremities. Tumor recurrence was not noticed in the oncologic patients.Conclusions:For selected patients, the RCAP propeller flap could be an alternative option for soft-tissue defect reconstruction in the upper extremity.
