Application of forearm radial artery perforator propeller flap for repair of hand and wrist soft tissue defects
10.3760/cma.j.cn114453-20230301-00045
- VernacularTitle:前臂桡动脉穿支螺旋桨皮瓣修复手及腕部软组织缺损
- Author:
Qiaochu ZHANG
1
;
Tao GUO
;
Jiaxiang GU
;
Wenzhong ZHANG
;
Wenjie WU
;
Tao XU
;
Chaoqun YUAN
;
Hongjun LIU
Author Information
1. 扬州大学临床医学院苏北人民医院手足外科，扬州 225001
- Keywords:
Radial artery;
Perforator flap;
Propeller flap;
Soft tissue defect;
Hand;
Wrist
- From:
Chinese Journal of Plastic Surgery
2023;39(9):953-959
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce the therapeutic effect of forearm radial artery perforator propeller flap for repair of hand and wrist soft tissue defects.Methods:The clinical data of patients with soft tissue defects of hand and wrist who received the treatment with forearm radial artery perforator propeller flap in Northern Jiangsu People’s Hospital from January 2018 to September 2020 were collected. The radial artery of the forearm was projected on the skin surface as the axis, and the nearest perforator was selected as the rotation point according to the location of the soft tissue defect. The radial artery perforator propeller flap was designed based on the location, area and shape of soft tissue defect. The length of the large paddle of the flap is equal to the distance between the proximal side of the wound edge and the rotation point plus the length of the wound, and the length of the small paddle of the flap is equal to the distance between the proximal side of the wound edge and the rotation point. The donor site was closed directly or with full-thickness skin graft from the ipsilateral upper arm. The survival, appearance of the flap and skin graft, hand and wrist function and patients satisfactory rate were observed and recorded.Results:A total of 6 patients were included, including 4 males and 2 females; the mean age was 40.5 years (range, 25-65 years ). There were 1 case on the palm side of the hand, 1 case on the dorsal side of the hand, 3 cases on the volar side of the wrist, and 1 case on the dorsal side of the wrist. The area of soft tissue defect after debridement was 2 cm × 3 cm-7 cm × 10 cm. The forearm radial artery perforator propeller flap ranged from 3 cm × 4 cm to 8 cm × 11 cm. The donor site was closed directly in 3 cases, and with full-thickness skin graft in 3 cases. The flaps in all 6 patients survived completely with primary healing. The skin grafts for the donor site in 3 cases survived completely. The patients were followed up for 3 months to 1 year, with an average of 5 months. The function of the hand and wrist recovered well. The texture of the flap was similar to that of the surrounding tissue with good appearance, no swelling or slight swelling, no obvious color difference. The donor site healed well without scar hyperplasia. The patients were satisfied with the surgical results.Conclusion:Propeller flap pedicled with forearm radial artery perforator is a simple and effective method to repair soft tissue defects of wrist and hand with reliable recovery of appearance and function. The patients’ satisfactory rate is also high.
