CLINICAL APPLICATION OF RADIAL MID-FOREARM PERFORATOR FASCIOCUTANEOUS FLAP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 XIEYun ¹ , LINJianhua ¹ , YEJunjian ¹ , ZHENGHeping ²

1. Department of Orthopaedics, the First Clinical Medical Hospital of Fujian Medical University, Fuzhou Fujian, 350005, P. R. China;
2. Department of Comparative Medicine, Fuzhou General Hospital of Nanjing Military Command;

Corresponding?author：

XIEYun, Email: xyxlr@126.com

Keywords：

Radial mid-forearm perforator fasciocutaneous flap; Soft tissue defect of the forearm; Wound repair

DOI：

10.7507/1002-1892.20140296

Video：

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Objective To investigate the effectiveness of using radial mid-forearm perforator fasciocutaneous flap to repair soft tissue defect in lower segment of the forearm and the wrist. Methods Between May 2007 and July 2012, 7 cases of soft tissue defect of lower segment of the forearm and the wrist were repaired with radial mid-forearm perforator fasciocutaneous flap. There were 6 males and 1 female with an average age of 38 years (range, 22-45 years). Defects were caused by crushing injury in 4 cases with the disease duration of 3-22 days (mean, 14 days), by internal fixation of ulnar comminuted fracture in 2 cases after 16 and 20 days of operation respectively, and by focal cleaning of wrist joint tuberculosis in 1 cases after 24 days of operation. The locations of defect were the lower segment of the forearm in 5 cases and the dorsal side of the wrist in 2 cases. The area of soft tissue defect ranged from 4 cm×3 cm to 9 cm×5 cm. The size of flap ranged from 6 cm×4 cm to 12 cm×6 cm. The donor site was closed with direct suturing or skin grafting. Results The intraoperative blood loss was 50-90 mL (mean, 64 mL); the operation time was 60-80 minutes (mean, 72 minutes). Six flaps survived with wound heal ing by first intention; partial flap necrosis occurred in 1 case, and delayed healing was obtained after dressing change. Skin grafting at donor sites survived with healing of incision by first intention. The patients were followed up 3-14 months (mean, 9 months). No ulcer or sinus tract was observed; all flaps showed a sl ightly swollen appearance and had normal color. Conclusion Radial mid-forearm perforator fasciocutaneous flap does not need to dissect the source of blood vessels due to constantly anatomical structure. It has the advantages of easy operation, rich blood supply, high survival rate, and satisfactory cl inical effect, so it is an important supplement of the other non-main vessel pedicle flaps to repair soft tissue defect in the lower segment of the forearm and the wrist.

Citation： XIEYun, LINJianhua, YEJunjian, ZHENGHeping. CLINICAL APPLICATION OF RADIAL MID-FOREARM PERFORATOR FASCIOCUTANEOUS FLAP. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(11): 1368-1371. doi: 10.7507/1002-1892.20140296 Copy

1.	張世民, 徐達傳, 俞光榮, 等.穿支皮瓣的發展與臨床應用進展.中國臨床解剖學雜志, 2006, 24(3):228-231, 239.
2.	Tajsic N, Winkel R, Husum H. Distally based perforator flaps for reconstruction of post-traumatic defects of the lower leg and foot. A review of the anatomy and cl inical outcomes. Injury, 2014, 45(3):469-477.
3.	Maciel-Miranda A, Morris SF, Hallock GG. Local flaps, including pedicled perforator flaps:anatomy, technique, and applications. Plast Reconstr Surg, 2013, 131(6):896e-911e.
4.	謝昀, 陳振光, 張發惠, 等.橈動脈肌間隙支前臂橈側中段皮瓣的應用解剖.中華顯微外科雜志, 2005, 28(2):148-149.
5.	鄭和平, 陳鵬, 洪發蘭, 等.前臂后外側中段穿支蒂皮神經營養血管皮瓣的應用解剖.中國臨床解剖學雜志, 2010, 28(4):358-362.
6.	Mei J, Morris SF, Ji W, et al. An anatomic study of the dorsal forearm perforator flaps. Surg Radiol Anat, 2013, 35(8):695-700.
7.	陳啟康, 侯致典, 王增濤, 等.橈動脈和尺動脈皮支鏈皮瓣的應用解剖.解剖學研究, 2009, 31(3):201-203, 207.
8.	趙民, 田德虎, 張英澤, 等.前臂遠端蒂復合血管網皮瓣修復腕手部皮膚缺損.中國修復重建外科雜志, 2005, 19(12):1001-1003.
9.	龐水發, 常湘珍, 張方晨, 等.皮瓣移植臨床應用應堅持原則.中華顯微外科雜志, 2010, 33(1):1-2.
10.	張發惠, 鄭和平, 田萬成, 等.前臂外側皮神經-頭靜脈營養血管遠端蒂復合瓣的應用解剖.中國臨床解剖學雜志, 2005, 23(2):118-121.
11.	林海濱, 林澗, 鄭曉暉, 等.前臂內側皮神經營養血管遠端蒂皮瓣的臨床應用.中國臨床解剖學雜志, 2008, 26(3):335-337.
12.	金玉丹, 羅少軍, 王綏江, 等.前臂外側皮神經-頭靜脈及其營養血管筋膜皮瓣的臨床應用.中華顯微外科雜志, 2008, 31(1):60-61.
13.	李澤龍, 謝逸波, 曾波, 等.貴要靜脈-前臂內側皮神經營養血管皮瓣的臨床應用.中華顯微外科雜志, 2006, 29(1):68-69.
14.	Hekner DD, Abbink JH, van Es RJ, et al. Donor-site morbidity of the radial forearm free flap versus the ulnarforearm free flap. Plast Reconstr Surg, 2013, 132(2):387-393.
15.	胡鵬, 唐修俊, 魏在榮, 等.前臂橈動脈腕上穿支鏈狀供血皮瓣修復手腕部創面的臨床應用.中國修復重建外科雜志, 2014, 28(4):491-494.
16.	林澗, 鄭和平, 余云蘭, 等.骨間后動脈遠端皮支鏈皮瓣移位修復手背皮膚缺損.中華顯微外科雜志, 2012, 35(5):421-422.
17.	卜凡玉, 薛明宇, 芮永軍, 等.改良前臂骨間背側動脈逆行島狀皮瓣修復手背部皮膚缺損療效觀察.中國修復重建外科雜志, 2014, 28(2):237-240.

1. 張世民, 徐達傳, 俞光榮, 等.穿支皮瓣的發展與臨床應用進展.中國臨床解剖學雜志, 2006, 24(3):228-231, 239.
2. Tajsic N, Winkel R, Husum H. Distally based perforator flaps for reconstruction of post-traumatic defects of the lower leg and foot. A review of the anatomy and cl inical outcomes. Injury, 2014, 45(3):469-477.
3. Maciel-Miranda A, Morris SF, Hallock GG. Local flaps, including pedicled perforator flaps:anatomy, technique, and applications. Plast Reconstr Surg, 2013, 131(6):896e-911e.
4. 謝昀, 陳振光, 張發惠, 等.橈動脈肌間隙支前臂橈側中段皮瓣的應用解剖.中華顯微外科雜志, 2005, 28(2):148-149.
5. 鄭和平, 陳鵬, 洪發蘭, 等.前臂后外側中段穿支蒂皮神經營養血管皮瓣的應用解剖.中國臨床解剖學雜志, 2010, 28(4):358-362.
6. Mei J, Morris SF, Ji W, et al. An anatomic study of the dorsal forearm perforator flaps. Surg Radiol Anat, 2013, 35(8):695-700.
7. 陳啟康, 侯致典, 王增濤, 等.橈動脈和尺動脈皮支鏈皮瓣的應用解剖.解剖學研究, 2009, 31(3):201-203, 207.
8. 趙民, 田德虎, 張英澤, 等.前臂遠端蒂復合血管網皮瓣修復腕手部皮膚缺損.中國修復重建外科雜志, 2005, 19(12):1001-1003.
9. 龐水發, 常湘珍, 張方晨, 等.皮瓣移植臨床應用應堅持原則.中華顯微外科雜志, 2010, 33(1):1-2.
10. 張發惠, 鄭和平, 田萬成, 等.前臂外側皮神經-頭靜脈營養血管遠端蒂復合瓣的應用解剖.中國臨床解剖學雜志, 2005, 23(2):118-121.
11. 林海濱, 林澗, 鄭曉暉, 等.前臂內側皮神經營養血管遠端蒂皮瓣的臨床應用.中國臨床解剖學雜志, 2008, 26(3):335-337.
12. 金玉丹, 羅少軍, 王綏江, 等.前臂外側皮神經-頭靜脈及其營養血管筋膜皮瓣的臨床應用.中華顯微外科雜志, 2008, 31(1):60-61.
13. 李澤龍, 謝逸波, 曾波, 等.貴要靜脈-前臂內側皮神經營養血管皮瓣的臨床應用.中華顯微外科雜志, 2006, 29(1):68-69.
14. Hekner DD, Abbink JH, van Es RJ, et al. Donor-site morbidity of the radial forearm free flap versus the ulnarforearm free flap. Plast Reconstr Surg, 2013, 132(2):387-393.
15. 胡鵬, 唐修俊, 魏在榮, 等.前臂橈動脈腕上穿支鏈狀供血皮瓣修復手腕部創面的臨床應用.中國修復重建外科雜志, 2014, 28(4):491-494.
16. 林澗, 鄭和平, 余云蘭, 等.骨間后動脈遠端皮支鏈皮瓣移位修復手背皮膚缺損.中華顯微外科雜志, 2012, 35(5):421-422.
17. 卜凡玉, 薛明宇, 芮永軍, 等.改良前臂骨間背側動脈逆行島狀皮瓣修復手背部皮膚缺損療效觀察.中國修復重建外科雜志, 2014, 28(2):237-240.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF RADIAL MID-FOREARM PERFORATOR FASCIOCUTANEOUS FLAP

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