The clinical application of individual design deep inferior epigastric perforator flap for resurfacing the various types of soft tissue defects in extremities
10.3760/cma.j.issn.1009-4598.2018.09.006
- VernacularTitle: 个性化设计腹壁下动脉穿支皮瓣在修复四肢皮肤软组织缺损中的临床应用
- Author:
Liming QING
1
;
Juyu TANG
;
Panfeng WU
;
Zhengbing ZHOU
;
Fang YU
;
Xiaoyang PANG
;
Ding PAN
;
Lei ZENG
;
Yongbing XIAO
;
Rui LIU
Author Information
1. Derpartment of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha 410008, China
- Publication Type:Clinical Trail
- Keywords:
Inferior epigastric artery;
Perforator flap;
Transplantation;
Limbs;
Soft tissue defect
- From:
Chinese Journal of Plastic Surgery
2018;34(9):709-714
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility and efficiency of deep inferior epigastric perforator flap (DIEP) based on individual design which was used for reconstructing the various types of soft tissue defects in extremities.
Methods:From September 2009 to October 2017, ninety three patients were included for respective analysis who presented with bone and tendon exposure or dead space, and reconstructed through individualized DIEP flaps in our department. We evaluated the appearance of donor site according to patients′satisfaction.
Results:Eight patients had pedicle DIEP flaps, 47 patients were treated with free traditional DIEP flaps, and 38 cases underwent with special forms of DIEP flaps. The special forms of DIEP flaps included 8 chimeric DIEP flaps, 13 dual skin paddles DIEP flaps, 12 microdissection DIEP flaps, 1 conjoined DIEP flap, 2 flow-through DIEP flaps, 1 mutipaddles chimeric DIEP flap and 1 microdissection dual skin paddles DIEP. The size of flap ranged from 7 cm×4 cm to 36 cm×11 cm. All of the donor sites were primarily closed.Most of flaps survived, only two cases suffered with necrosis due to vascular crisis. Those patients have been followed-up from 5 to 24 months (average 12.4 months). A good color and texture were achieved in most of recipient sites. 16.1% of patients needed the second debulking procedure. The function of abdominal wall was normal postoperatively. Transverse flap design was performed for 32 patients, oblique design for 46 patients, irregular design for 13 patients, and longitudinal design for 2 patients. The rate of excellent donor site appearance was 86.9% in the transverse designed flaps, 70.0% for the donor site with the oblique designed flap, and 37.5% for the donor site with the irregular designed flap.
Conclusions:The individualized DIEP flaps based on different wound characteristics are ideal approaches for reconstruction of various types of soft tissue defects in extremities.
