Coryoint flap of lower abdominal wall for covering extremely large soft tissue circular defects on limbs
10.3760/cma.j.cn441206-20220829-00172
- VernacularTitle:下腹壁联合皮瓣修复四肢大面积软组织环形缺损
- Author:
Yu HUANG
1
;
Bo HUANG
;
Anming LIU
;
Lin TANG
;
Xin ZHOU
;
Shaoliang WANG
;
Yonggen ZOU
Author Information
1. 西南医科大学附属中医医院手外科，四川 泸州 646000
- Keywords:
Lower abdominal wall;
Coryoint flap;
Limbs;
Soft tissue defect;
Reconstruction
- From:
Chinese Journal of Microsurgery
2023;46(1):44-49
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the results of coryoint flap harvested from lower abdominal wall for covering extremely soft tissue circular defects on limbs.Methods:From March 2018 to June 2020, 15 patients who suffered from severe degloved injury were admitted into the Department of Hand Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. The injuries were characterised as extreme circular defects on limbs. The dimension of defects ranged from 25.0 cm×9.0 cm to 30.0 cm×18.0 cm. All wounds were taken through emergency debridement and managed by VSD. Using lower abdomen as a donor site, a conjoined flap was dissected when the wound surface became granulating. The perforator vessels of the flaps included vessels of deep inferior epigastric artery(DIEA), superficial inferior epigastric artery(SIEA) and superficial circumflex iliac artery(SCIA). The donor sites were primary closed. Postoperative follow-ups were conducted by the surgeons in the same surgical team at outpatient clinic.Results:Fourteen flaps survived completely without significant complications. Distal necrosis occurred in 1 flap, which healed with a skin graft in the second stage surgery. All flaps were reviewed during the postoperative follow-up that lasted for 18-24(mean 20) months. The aesthetic outcomes were achieved on the recipient site without hairy nor hyper-pigmentation. A concealed linea scare left at the donor sites without hernia and limited function. At the last follow-up, 5 patients were in excellent and 2 in good evaluated by following the Disabilities of the arm, shoulder and hand(DASH). With the Lower extremity functional scale(LEFS), 5 patients were in excellent and 3 in good.Conclusion:The simultaneous reconstruction of extremely large soft tissue circular defects on limbs with best possible salvage surgery can be achieved by a conjoined flap. A conjoined flap offers a concealed donor site, easy to design, flexible perforators design and larger size of soft tissue.
