EFFECTIVENESS OF FREE ANASTOMOSIS CUTANEOUS NERVE DOUBLE ARTERIALIZED VENOUS FLAP GRAFT FOR REPAIRING FINGER DEFECT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LUHui , WANGWengang , WUHuiling , LUORenman , WEIWei , WANGXudong

Department of Microsurgery, Tangxia Hospital of Dongguan, Dongguan Guangdong, 523710, P. R. China;

Corresponding?author：

LUHui, Email: 40793814@qq.com

Keywords：

Finger defect; Forearm double arterialized venous flap; Anastomosis nerve; Wound repair

DOI：

10.7507/1002-1892.20140156

Video：

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Objective To explore the effectiveness of the free anastomosis cutaneous nerve double arterialized venous flap graft in repairing finger defect. Methods Between May 2010 and May 2013, 39 patients with finger defect were treated. There were 27 males and 12 females with an average age of 31 years (range, 17-45 years). The injury to admission time was 30-90 minutes (mean, 60 minutes). The causes included mechanical injury in 23 cases, crush injury in 11 cases, and other injury in 5 cases. The thumb was involved in 13 cases, the index finger in 11 cases, the middle finger in 9 cases, the ring finger in 4 cases, and the little finger in 2 cases. Skin soft tissue defect ranged from 2 cm×1 cm to 4 cm×2 cm. of them, 22 cases had tendon injury, 17 cases had tendon and phalanx injuries. The size of free anastomosis cutaneous nerve double arterialized venous flap ranged from 2.5 cm×1.5 cm to 4.5 cm×2.5 cm. The donor site was directly sutured. Results Tension blister and swelling were observed at distal flap in 5 cases at 3-5 days after operation and were cured after symptomatic treatment; the other 34 flaps survived, and wound healed by first intention. Primary healing at donor site was obtained. The patients were followed up 6-12 months (mean, 9 months). The flap appearance and texture were good with two-point discrimination of 6-9 mm (mean, 7.5 mm). According to the upper extremity function evaluation criteria issued by the Hand Surgery Society of Chinese Medical Association, the results were excellent in 35 cases and good in 4 cases. Conclusion The free anastomosis cutaneous nerve double arterialized venous flap not only can ensure the flap blood supply, but also can obviously improve the sensory function of the flap, which greatly reduces the risk of postoperative flap atrophy, and can achieved satisfactory effectiveness.

Citation： LUHui, WANGWengang, WUHuiling, LUORenman, WEIWei, WANGXudong. EFFECTIVENESS OF FREE ANASTOMOSIS CUTANEOUS NERVE DOUBLE ARTERIALIZED VENOUS FLAP GRAFT FOR REPAIRING FINGER DEFECT. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(6): 707-709. doi: 10.7507/1002-1892.20140156 Copy

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13.	王懷玉, 王寶, 張明慧, 等. 指動脈島狀皮瓣在手指電燒傷中的應用. 實用手外科雜志, 2008, 22(2):109.
14.	柏樹令. 系統解剖學. 6版. 北京:人民衛生出版社, 2004:401.
15.	張世民, 徐達傳. 帶皮神經及其營養血管的皮瓣. 中國臨床解剖學雜志, 1996, 14(4):313-315.
16.	徐亞非, 伍美藝, 張德軍, 等. 應用改良動脈化靜脈皮瓣修復指部軟組織缺損. 中華顯微外科雜志, 2011, 34(4):321-322.

1. Yoshimura M, Shimada T, Imura S, et al. The venous skin graft methocl for repairing Skin defects of the fingers. Plast Reconstr Surg, 1987, 79(2):243-250.
2. Moshammer HE, Schwarzl FX, Haas FM, et al. Retrograde arterialized venous flap:an experimental study. Microsurgery, 2003, 23(2):130-134.
3. 陳劍名, 粱建, 陳正耿. 動脈化靜脈皮瓣微循環方式的實驗研究. 中國修復重建外科雜志, 2002, 16(3):170-172.
4. 李瑞華, 闞世廉, 李明新. 動脈化靜脈皮瓣急診修復手指軟組織缺損. 中國修復重建外科雜志, 2008, 22(7):797-799.
5. 楊衛東, 童致虹, 孫煥偉, 等. 動脈化靜脈皮瓣修復手指軟組織缺損. 中國修復重建外科雜志, 2007, 21(6):656-657.
6. 劉學貴, 張銘盛, 楊俊貴, 等. 改良動脈化游離靜脈皮瓣的臨床應用. 中華手外科雜志, 2007, 23(4):224-226.
7. 潘達德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3):130-135.
8. 劉秉銳, 馬洪光, 紀善燕. 指動脈逆行皮瓣與鄰指皮瓣瓦合修復單指中遠節皮膚缺損. 中國修復重建外科雜志, 2005, 19(4):286.
9. 楊華, 劉傳太, 唐葆青, 等. 帶蒂皮瓣修復手指軟組織缺損. 中國修復重建外科雜志, 2004, 18(4):341-342.
10. 張磊, 于華, 王培森. 逆行鄰指指動脈島狀皮瓣修復全指腹缺損. 實用手外科雜志, 2007, 21(3):161.
11. 王文德, 王鑫, 趙亮, 等. 帶蒂鄰指指動脈島狀皮瓣修復手指皮膚缺損. 中華手外科雜志, 2007, 23(1):7.
12. 劉愛波, 姜德欣, 李大為. 鄰指指動脈島狀皮瓣的臨床應用. 中華手外科雜志, 2006, 22(3):182.
13. 王懷玉, 王寶, 張明慧, 等. 指動脈島狀皮瓣在手指電燒傷中的應用. 實用手外科雜志, 2008, 22(2):109.
14. 柏樹令. 系統解剖學. 6版. 北京:人民衛生出版社, 2004:401.
15. 張世民, 徐達傳. 帶皮神經及其營養血管的皮瓣. 中國臨床解剖學雜志, 1996, 14(4):313-315.
16. 徐亞非, 伍美藝, 張德軍, 等. 應用改良動脈化靜脈皮瓣修復指部軟組織缺損. 中華顯微外科雜志, 2011, 34(4):321-322.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF FREE ANASTOMOSIS CUTANEOUS NERVE DOUBLE ARTERIALIZED VENOUS FLAP GRAFT FOR REPAIRING FINGER DEFECT

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