Comparison of therapeutic effects between retrograde island flap of innate artery and dorsal perforator island flap for repairing skin defects at the distal phalanx of fingers
10.3969/j.issn.1005-6483.20231396
- VernacularTitle:指固有动脉逆行岛状皮瓣和背侧穿支岛状皮瓣修复手指远节末端皮肤缺损的疗效对比
- Author:
Peng ZHOU
1
;
Hao HU
;
Xu HUANG
;
Shengdong MENG
;
Yankun DAI
Author Information
1. 223022 江苏省淮安市第二人民医院手足外科
- Keywords:
distal finger;
distal phalanx;
skin defect;
island flap repair surgery;
collateral artery of the finger;
dorsal branch artery of the finger
- From:
Journal of Clinical Surgery
2024;32(11):1185-1189
- CountryChina
- Language:Chinese
-
Abstract:
Objective Comparison of therapeutic effects between retrograde island flap of the intrinsic artery and dorsal perforator island flap for repairing skin defects at the distal phalanx of the finger.Methods A total of 128 patients with skin defects at the distal phalanx of the finger were enrolled from August 2020 to September 2022 at Huai'an Second People's Hospital.These patients had 128 affected fingers.Using a random number table,they were divided into two groups:collateral group(64 case)and dorsal branch group(64 case).The collateral group underwent retrograde island flap surgery using the intrinsic artery,while the dorsal branch group underwent repair surgery using the dorsal perforator island flap of the intrinsic artery.Surgical time and intraoperative blood loss were recorded.Follow-up was conducted for 12 months postoperatively,evaluating graft survival rate,finger joint function,sensory function of the transplanted flap at the distal phalanx,degree of wound scar,and postoperative complications.Results The surgical time for the collateral branch group and the dorsalis branch group was(50.03±12.41)minutes and(54.78±15.65)minutes,respectively.The intraoperative blood loss was(22.65±10.03)ml in the collateral branch group and(26.52±12.61)ml in the dorsalis branch group.There was no statistically significant difference in surgical time or intraoperative blood loss between the two groups(P＞0.05).At the 12-month follow-up,all patients in both groups had normal healing of the distal defect,and the success rate of flap transplantation was 100.00％in both groups.There was no statistically significant difference between the groups in terms of flap transplantation success rate(P＞0.05).At the 12-month postoperative period,the Vancouver Scar Scale(VSS)score was(3.15±0.69)in the collateral branch group and(3.17±0.62)in the dorsalis branch group,with no statistically significant difference between the two groups(P＞0.05).The Tangibility,Appearance,and Mobility(TAM)score was(9.71±0.65)in the collateral branch group and(10.93±0.71)in the dorsalis branch group.The TAM score was significantly lower in the collateral branch group compared to the dorsalis branch group(P＜0.05).The two-point discrimination of the flaps was(8.93±2.05)mm in the collateral branch group and(7.51±1.64)mm in the dorsalis branch group.The two-point discrimination was significantly higher in the collateral branch group compared to the dorsalis branch group(P＜0.05).There were 2 cases of venous reflux disorder and 1 case of cold intolerance in the collateral branch group,while no complications occurred in the dorsalis branch group.There was no statistically significant difference in complications between the two groups(P＞0.05).Conclusion Compared to the reverse island flap repair using the intrinsic arterial system,the dorsal island flap repair using the intrinsic arterial system for treating distal skin defects of the finger provides better postoperative functional recovery of the finger and relatively lower risk of venous congestion.
