Repair of soft tissue defects of hand and foot with free medial sural artery perforator flap
10.3760/cma.j.cn114453-20210128-00048
- VernacularTitle:游离腓肠内侧动脉穿支皮瓣修复手部及足部皮肤软组织缺损
- Author:
Zuguo XIONG
1
;
Weiya QI
;
Yilihamu YILIZATI·
;
Kaichao GUO
Author Information
1. 徐州仁慈医院手显微外科，徐州 221004
- Keywords:
Hand injuries;
Foot injuries;
Surgical flaps;
Medial sural artery perforator flap;
Repair
- From:
Chinese Journal of Plastic Surgery
2022;38(3):304-310
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of free medial sural artery perforator flap (MSAP) in repairing skin and soft tissue defects of hand and foot.Methods:The clinical data of patients with soft tissue defects of hand and foot who were treated by the free MSAP in Xuzhou Renci Hospital from January 2017 to December 2019 were analyzed retrospectively. When repairing the wound of the foot, the donor site was harvested from the ipsilateral lower limb; when repairing the wound of the hand, the donor site was harvested from the ipsilateral or contralateral lower limb. Regular follow-up was carried out through outpatient reexamination, WeChat and telephone. The hand scoring criterion was the upper extremity functional evaluation standard set up by the Chinese Society of Hand Surgery of the Chinese Medical Association; the foot scoring criterion was the Maryland score system.Results:All 10 patients were involved, including 5 males and 5 females. The mean age was 44.8 years (ranging from 16 to 56 years). There were 8 cases of hand wounds and 2 cases of and foot wounds. The MSAP size was 4.0 cm×7.0 cm-5.0 cm×14.0 cm. The lower leg donor site was closed primarily. The cutaneous nerves were anastomosed in seven cases. All flaps survived in 10 patients and primary healing after the operation. One flap had a vascular crisis after the operation and survived after the vascular exploratory operation. Nine cases were followed up for 6-12 months; the mean follow-up time was 8 months. the MSAP was in good shape, the sensation of the flap recovered to grade S2-S3, and the two-point discrimination was 7-9 mm. The hand and foot function returned to normal. The flap in the weight-bearing area was not broken. The movement and sensation of the lower limbs in the donor area were normal without dysfunction. At the last follow-up, hand function was evaluated: 6 cases were excellent and 1 case was good; the evaluation of foot function was excellent in 2 cases. One patient was lost to follow-up.Conclusions:The free MSAP does not damage the main blood vessels; the perforating branches are relatively constant, the vascular pedicle is long, and the subcutaneous fat layer is thin. The effect of repairing the wound of hand and foot is good.
