Reconstruction of soft tissue defect of hand and foot with a free superficial circumflex iliac artery perforator flap in children
10.3760/cma.j.cn441206-20240425-00109
- VernacularTitle:游离旋髂浅动脉穿支皮瓣修复小儿手及足软组织缺损
- Author:
Xin CHEN
1
;
Qiaoqiao YUAN
;
Zhenlei SONG
;
Gangqiang LI
;
Kun YANG
;
Yanjuan ZHANG
;
Nuo XU
;
Guangyi MA
Author Information
1. 周口淮海医院手足外科，周口市手足外科临床医学研究中心,河南 周口 466001
- Keywords:
Superficial circumflex iliac artery perforator flap;
Children;
Hand;
Foot;
Soft tissue defect
- From:
Chinese Journal of Microsurgery
2024;47(5):508-513
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of free superficial circumflex iliac artery perforator flap (SCIAPF) in reconstruction of soft tissue defects of hand and foot in children.Methods:From August 2021 to August 2023, free SCIAPFs were used to reconstruct soft tissue defects of hands and feet in 8 children at the Department of Hand and Foot Surgery, Zhoukou Huaihai Hospital. There were 6 boys and 2 girls aged between 2 and 7 years old. The sites of soft tissue defect were: 1 of metacarpophalangeal joint in the functional area of left thumb, 2 of dorsal right hand, 1 of dorsal left foot, 2 of medial malleolus of right foot, and 2 of right forefoot, and all were accompanied with tendon and bone exposure. The size of soft tissue defects ranged from 2.5 cm×3.0 cm to 6.0 cm×3.5 cm. After emergency debridement, the children received flap transfers, the flaps sized from 3.0 cm×3.5 cm to 7.0 cm×4.0 cm. Donor sites were closed by running intradermal suture. All children were included in the scheduled postoperative follow-up by visit of outpatient clinic, WeChat interviews and home visits to observe the appearance, colour, texture and sensation of the flaps, the functional recovery of the affected hands and feet, as well as the healing of donor sites.Results:After surgery, all 8 flaps survived beside 1 had a partial necrosis at the edge and healed with a scab after dressing change. Flap donor sites healed in one stage. Scheduled postoperative follow-up lasted from 7 to 22 months, with an average of 10 months. The flaps presented a slightly bloated appearance, soft texture with a restored protective sensation and satisfactory functional recovery of hands and feet. Linear scars were left at the donor sites. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 1 child was of excellent and 2 children of good in hand function of the 3 children with hand injury. The Maryland Foot Score revealed 3 children were of excellent and 2 of good in foot function of the 5 children with foot injury.Conclusion:Free SCIAPF is an ideal option for reconstruction of soft tissue defects of hand and foot in children, with concealed donor site, convenient flap harvesting, fewer complications and satisfactory reconstructive effect.
