Application of free interosseous posterior artery perforator flap in small hand defects
10.3760/cma.j.cn114453-20210316-00115
- VernacularTitle:游离骨间后动脉穿支皮瓣在小面积手部皮肤软组织缺损中的应用
- Author:
Chi ZHANG
1
;
Guangfeng SUN
;
Xing YOU
;
Kerong TAO
;
Ye LIU
;
Jing XIAO
;
Lingyan DUAN
Author Information
1. 遵义医科大学第二附属医院烧伤整形外科 563000
- Keywords:
Hand injuries;
Perforator flap;
Interosseous posterior artery
- From:
Chinese Journal of Plastic Surgery
2021;37(9):1007-1012
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of free interosseous posterior artery perforator flap in small hand defects.Methods:We retrospectively analyzed the case data of small hand skin and soft tissue defects treated with free interosseous posterior arterial perforator flaps from March 2019 to August 2020 in the Department of Burn Plastic Surgery, the Second Affiliated Hospital of Zunyi Medical University. According to the size of the defect during the operation, we designed free interosseous posterior artery perforator flap transplantation to repair wounds, and the perforating branch of the posterior interosseous artery is anastomosed with the proper digital artery and the common digital artery. The donor valve area is sutured directly. After the operation, the survival of the flaps was observed, and the repair effect of the flaps, hand function and complications were followed up.Results:Twenty-one cases were included, among whom there were 15 males and 6 females with a median age of 46 years (range, 23-61years). There were several causes of injury: 7 cases of heavy object injuries, 11 of machine strangulation, 3 of burns and scalds. For 8 cases, the defect sites were on the palms and 13 on the dorsal sites. The defect size ranged from 1.5 cm×2.0 cm to 3.0 cm×9.0 cm with exposed tendons and bones. The flap size ranged from 2.0 cm×2.0 cm to 3.5 cm×9.0 cm. Among them, compound tissue transplantation with tendon was used to reconstruct finger extension function in 1 case while tissue transplantation with nerve was used to repair the palmar wounds in 2 cases. The bilobed flaps were used in 4 cases, and the remaining 14 cases were single leaf free skin flaps. No arteriovenous crisis occurred in the flaps after the operation. All flaps of 21 patients survived, and there was no blood supply disorder in the flaps. After 6-12 months of follow-up, the texture and color of the flap were similar to adjacent skin, and unrestricted hand function was unrestricted. The two-point discernibility of the skin flap for patients with nerve grafts was 10-12 mm, serious complication in the donor sites, but the forearm donor area with linear scars.Conclusions:The application of interosseous posterior artery perforator flap is flexible. It can repair two adjacent small wounds at the same time with free bilobed transplantation, and can carry free cutaneous nerve transplantation to repair the palm side wound. This flap is one of the ideal flaps for repairing small defects on the hand.
