Clinical study on functional perforator flap with sensory reconstruction for repairing complex defects on limbs.
10.7507/1002-1892.202505088
- Author:
Lin TANG
1
;
Shuqing HUANG
2
;
Jiaping ZHANG
3
;
Xin ZHOU
3
Author Information
1. Department of Orthopedics, Jiangbei Campus, the First Affiliated Hospital of Army Medical University of Chinese PLA, Chongqing, 400020, P. R. China.
2. Department of Plastic and Cosmetic Surgery, the Second Hospital of Army Medical University of Chinese PLA, Chongqing, 400037, P. R. China.
3. Department of Plastic and Cosmetic Surgery, the First Affiliated Hospital of Army Medical University of Chinses PLA, Chongqing, 400038, P. R. China.
- Publication Type:Journal Article
- Keywords:
Functional perforator flap;
complex defects;
functional repair;
limb;
sensation reconstruction
- MeSH:
Humans;
Male;
Adult;
Female;
Perforator Flap/transplantation*;
Middle Aged;
Plastic Surgery Procedures/methods*;
Retrospective Studies;
Young Adult;
Treatment Outcome;
Extremities/injuries*;
Cicatrix/surgery*;
Skin Transplantation/methods*
- From:
Chinese Journal of Reparative and Reconstructive Surgery
2025;39(9):1091-1097
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the clinical outcome of sensory reconstruction about the functional perforator flap for repairing the complex defects on the limbs.
METHODS:A retrospective analysis was conducted on 21 patients with limb complex defects admitted between March 2018 and January 2023. There were 12 males and 9 females, with a median age of 36 years (range, 19-62 years). The wounds were on the upper limbs (hands) in 13 cases and the lower limbs (feet) in 8 cases. Five patients with tumor/scar, and the left defects after en-bloc resection of the tumor lesion and scar were repaired immediately. The remaining 16 cases were acute/chronic wounds, undergoing the emergent debridement and vacuum sealing drainage placement, and the left defects were repaired with flaps during second-stage operation. The size of the defects ranged from 5.5 cm×4.5 cm to 17.0 cm×12.0 cm. The donor sites were located on the thoracic and back in 4 cases, the anterior lateral thigh in 6 cases, and the feet in 11 cases. All flaps were functional perforator flaps with sensory nerve. The donor sites were closed directly or repaired with skin grafting. At last follow-up, the sensation of flap and the muscle strength of recipient site were evaluated according to the British Medical Research Council (BMRC) sensory grading (S0-S4) and muscle strength grading (M0-M5) criteria.
RESULTS:Twenty flaps survived completely without significant complication, and partial edge necrosis was observed in 1 flap, which healed after the debridement and skin grafting. The donor and recipient sites healed by first intention. All patients were followed up 10-18 months (mean, 12 months). At last follow-up, the flaps with satisfactory shape and soft texture were observed, and no abnormal hair growth or pigmentation occurred. The sensation of flap was evaluated as S1 in 2 cases, S2 in 7, S3 in 9, and S4 in 3. The muscle strength of recipient site was evaluated as M2 in 4 cases, M3 in 9, M4 in 5, and M5 in 3. Only linear scars were left at the donor site.
CONCLUSION:The functional perforator flap with sensory nerve is beneficial for early sensation reconstruction for repairing the complex defects on the limbs, and could reconstruct the functional subunit structure defect in one stage. The short-term functional follow-up results are satisfactory.
