Application effect of the flap based on ascending branch of the supracarpal cutaneous branch of ulnar artery with venous superdrainage in repairing skin defects of wrist and hand
10.3760/cma.j.cn114453-20220526-00163
- VernacularTitle:超回流技术在尺动脉腕上皮支皮瓣修复手、腕部皮肤缺损中的应用效果
- Author:
Hongtao WANG
1
;
Hui WANG
;
Yihan ZHANG
;
Ao XU
;
Zichen LYU
Author Information
1. 唐山市第二医院手外科，唐山 063000
- Keywords:
Surgical flaps;
Supracarpal cutaneous branch of the ulnar artery;
Skin injury;
Venous superdrainage;
Venous anastomosis
- From:
Chinese Journal of Plastic Surgery
2022;38(11):1270-1275
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application effect of venous superdrainage in repairing skin defects of wrist and hand with the flap based on ascending branch of the supracarpal cutaneous branch of ulnar artery.Methods:From July 2014 to March 2021, the clinical data of patients with hand and wrist skin defects repaired with the flap based on ascending branch of the supracarpal cutaneous branch of ulnar artery in the Emergency Department of Tangshan Second Hospital were retrospectively analyzed. According to the intraoperative venous anastomosis or not the patients were divided into venous superdrainage group(from July 2017 to March 2021) and traditional group(from July 2014 to June 2017). On the basis of the traditional method, the subcutaneous vein carried by the flap and the subcutaneous vein around the wound were anastomosed end to end in the venous superdrainage group. The donor sites in both groups were directly sutured or repaired with free partial or full thickness skin grafts. The survival of flaps in the two groups was observed after operation. Fisher’s exact test was used to compare the incidence of tension blister and pigmentation between the two groups. P<0.05 was considered statistically significant. Results:A total of 51 patients were enrolled. There were 27 patients in the venous superdrainage group, which including 18 males and 9 females, aged 18 to 57 years. The wound area after debridement ranged from 6 cm × 2 cm to 13 cm × 4 cm. There were 24 patients in traditional group, which including 15 males and 9 females, aged 20 to 61 years. The wound size after debridement ranged from 7 cm × 2 cm to 14 cm × 3 cm. In the venous superdrainage group, the flap size ranged from 7 cm × 3 cm to 15 cm × 6 cm. All the flaps survived without infection and tension blisters. During the follow-up period of 8 to 22 months, one flap showed pigmentation. In the traditional group, the area of flaps ranged from 8 cm × 3 cm to 16 cm × 4 cm. Tension blisters occurred in 5 cases of flaps due to venous reflux disorder, and the flaps survived without infection after removing some sutures at the pedicle and dressing change. During the follow-up period of 8 to 23 months, seven flaps showed pigmentation. The incidences of tension blisters and pigmentation in the venous superdrainage group were 0 (0/27) and 3.7% (1/27), respectively, which were significantly lower than those in the traditional group [20.8% (5/24) and 29.2% (7/24)] (both P<0.05). Conclusions:The use of venous superdrainage in the repair of hand and wrist skin defects with the ascending branch of the supracarpal cutaneous branch of ulnar artery flap can reduce the risk of venous reflux disorders, decrease the incidences of tension blisters and pigmentation of the flap significantly.
