APPLICATION OF THE DOUBLE SKIN PADDLE ARTERIALIZED VENOUS FLAPS FOR RECONSTRUCTING SOFT TISSUE DEFECTS OF MIDDLE AND PROXIMAL PARTS OF DOUBLE FIGURES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANGShuaizhi ¹ , CHENLu ¹ ,  ZHENGCanbin ² , YANGJungui ¹ , HUANGYu ¹ , CUIJiande ¹

1. Department of Hand Surgery, the Fifth People's Hospital of Foshan (the Affiliated Hospital of Foshan Technical College), Foshan Guangdong, 528211, P. R. China;
2. Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University;

Corresponding?author：

ZHENGCanbin, Email: zhengcanbin@qq.com

Keywords：

Double skin paddle arterialized venous flap; Double fingers injury; Soft tissue defect; Repair

DOI：

10.7507/1002-1892.20160088

Video：

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Objective To investigate the application of the double skin paddle arterialized venous flaps for reconstruction of soft tissue defects in the middle and proximal parts of double fingers. Method Between September 2011 and December 2014, 6 cases (12 fingers) of soft tissue defects in the middle and proximal parts of double fingers underwent reconstructive surgery with the double skin paddle arterialized venous flaps. There were 5 males and 1 female with an average age of 33.8 years (range, 19-52 years). The causes included cut injury in 4 cases and crush injury in 2 cases. Five index fingers, 3 middle fingers, 2 ring fingers, and 2 little fingers were involved. All defects located at proximal and middle fingers and defect did not exceed the distal interphalangeal joint. The defect area ranged from 2.5 cm×2.5 cm to 5.5 cm×4.0 cm. All cases had bone or tendon exposure, and 2 cases had phalangeal fracture. The disease duration was 1.5-7 hours (mean, 3.5 hours). The flap size was 8 cm×3 cm-14 cm×5 cm. The donor site was directly sutured (≤ 3.0 cm in width) or was repaired with skin graft (>3.0 cm in width). Results The operation time was 2.5-5.0 hours (mean, 4.0 hours). All flaps survived completely. Tensive blisters occurred in 4 cases and were improved at 1 week after removal of suture around pedicle. Partial distal flap necrosis was noted in 1 case, healing was obtained after secondary debridement; other wounds healed in one stage. The patients were followed up 6-18 months (mean, 13 months). The flap had good texture, elasticity, and appearance. According to the hand function evaluation criteria issued by the Chinese Hand Society, the results were excellent in 3 cases, good in 2 cases, and fair in 1 case at last follow-up. The two-point discrimination of the flap was 8-10 mm (mean, 9 mm). Conclusions The double skin paddle arterialized venous flaps have the advantages of simple technique and definite effectiveness for reconstruction of soft tissue defects in the middle and proximal part of double fingers.

Citation： YANGShuaizhi, CHENLu, ZHENGCanbin, YANGJungui, HUANGYu, CUIJiande. APPLICATION OF THE DOUBLE SKIN PADDLE ARTERIALIZED VENOUS FLAPS FOR RECONSTRUCTING SOFT TISSUE DEFECTS OF MIDDLE AND PROXIMAL PARTS OF DOUBLE FIGURES. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(4): 440-443. doi: 10.7507/1002-1892.20160088 Copy

1.	Meky M, Safoury Y. Composite anterolateral thigh perforator flaps in the management of complex hand injuries. J Hand Surg (Eur Vol), 2013, 38(4) :366-370.
2.	Marinescu S, Florescu IP, Giuglea C, et al. Free tissue transfer in hand surgery-essential step in hand transplantation. Chirurgia (Bucur), 2012, 107(1) :79-88.
3.	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) :130-132.
4.	Chen C, Tang P, Zhang L, et al. Repair of multiple finger defects using the dorsal homodigital island flaps. Injury, 2013, 44(11) :1582-1588.
5.	Pan ZH, Jiang PP, Xue S. Free iliac flap for treating multiple skin defects of the hand and digits. J Hand Surg (Eur Vol), 2013, 38(9) :952-958.
6.	Trovato MJ, Brooks D, Buntic RF, et al. Simultaneous coverage of two separate dorsal digital defects with a syndactylizing venous free flap. Microsurgery, 2008, 28(4) :248-251.
7.	Ulrich D, Pallua N. Treatment of avulsion injury of three fingers with a compound thoracodorsal artery perforator flap including serratus anterior fascia. Microsurgery, 2009, 29(7) :556-559.
8.	李炳森, 吳琳, 王本亮, 等. 單蒂雙葉髂腹股溝皮瓣修復復雜性手外傷. 實用手外科雜志, 2008, 22(3) :144-146.
9.	Gao W, Hong J, Li Z, et al. Hand reconstruction with lobulated combined flaps based on the circumflex scapular pedicle. Microsurgery, 2008, 28(5) :355-360.
10.	Li KW, Liu J, Liu MJ, et al. Free multilobed posterior interosseous artery perforator flap for multi-finger skin defect reconstruction. J Plast Reconstr Aesthet Surg, 2015, 68(1) :9-16.
11.	Nakayama Y, Soeda S, Kasai Y. Flaps nourished by arterial inflow through the venous system:an experimental investigation. Plast Reconstr Surg, 1981, 67(3) :328-334.
12.	李德平, 劉學貴, 毛波, 等. 改良前臂雙干型靜脈動脈化皮瓣修復手部軟組織缺損. 實用醫學雜志, 2014, 30(12) :1967-1970.
13.	曾志超, 吉趙勇, 李鵬. 靜脈動脈化皮瓣在復雜手指外傷中的應用. 中華創傷骨科雜志, 2006, 8(11) :1080-1081.
14.	Hyza P, Vesely J, Stupka I, et al. The bilobed arterialized venous free flap for simultaneous coverage of 2 separate defects of a digit. Ann Plast Surg, 2005, 55(6) :679-683.
15.	Kayalar M, Levent K, Sugun TS, et al. Syndactylizing arterialized venous flaps for multiple finger injuries. Microsurgery, 2014, 34(7) :527-534.
16.	Kayalar M, Kucuk L, Sugun TS, et al. Clinical applications of free arterialized venous flaps. J Plast Reconstr Aesthet Surg, 2014, 67(11) :1548-1556.
17.	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.

1. Meky M, Safoury Y. Composite anterolateral thigh perforator flaps in the management of complex hand injuries. J Hand Surg (Eur Vol), 2013, 38(4) :366-370.
2. Marinescu S, Florescu IP, Giuglea C, et al. Free tissue transfer in hand surgery-essential step in hand transplantation. Chirurgia (Bucur), 2012, 107(1) :79-88.
3. 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) :130-132.
4. Chen C, Tang P, Zhang L, et al. Repair of multiple finger defects using the dorsal homodigital island flaps. Injury, 2013, 44(11) :1582-1588.
5. Pan ZH, Jiang PP, Xue S. Free iliac flap for treating multiple skin defects of the hand and digits. J Hand Surg (Eur Vol), 2013, 38(9) :952-958.
6. Trovato MJ, Brooks D, Buntic RF, et al. Simultaneous coverage of two separate dorsal digital defects with a syndactylizing venous free flap. Microsurgery, 2008, 28(4) :248-251.
7. Ulrich D, Pallua N. Treatment of avulsion injury of three fingers with a compound thoracodorsal artery perforator flap including serratus anterior fascia. Microsurgery, 2009, 29(7) :556-559.
8. 李炳森, 吳琳, 王本亮, 等. 單蒂雙葉髂腹股溝皮瓣修復復雜性手外傷. 實用手外科雜志, 2008, 22(3) :144-146.
9. Gao W, Hong J, Li Z, et al. Hand reconstruction with lobulated combined flaps based on the circumflex scapular pedicle. Microsurgery, 2008, 28(5) :355-360.
10. Li KW, Liu J, Liu MJ, et al. Free multilobed posterior interosseous artery perforator flap for multi-finger skin defect reconstruction. J Plast Reconstr Aesthet Surg, 2015, 68(1) :9-16.
11. Nakayama Y, Soeda S, Kasai Y. Flaps nourished by arterial inflow through the venous system:an experimental investigation. Plast Reconstr Surg, 1981, 67(3) :328-334.
12. 李德平, 劉學貴, 毛波, 等. 改良前臂雙干型靜脈動脈化皮瓣修復手部軟組織缺損. 實用醫學雜志, 2014, 30(12) :1967-1970.
13. 曾志超, 吉趙勇, 李鵬. 靜脈動脈化皮瓣在復雜手指外傷中的應用. 中華創傷骨科雜志, 2006, 8(11) :1080-1081.
14. Hyza P, Vesely J, Stupka I, et al. The bilobed arterialized venous free flap for simultaneous coverage of 2 separate defects of a digit. Ann Plast Surg, 2005, 55(6) :679-683.
15. Kayalar M, Levent K, Sugun TS, et al. Syndactylizing arterialized venous flaps for multiple finger injuries. Microsurgery, 2014, 34(7) :527-534.
16. Kayalar M, Kucuk L, Sugun TS, et al. Clinical applications of free arterialized venous flaps. J Plast Reconstr Aesthet Surg, 2014, 67(11) :1548-1556.
17. 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.

Chinese Journal of Reparative and Reconstructive Surgery

APPLICATION OF THE DOUBLE SKIN PADDLE ARTERIALIZED VENOUS FLAPS FOR RECONSTRUCTING SOFT TISSUE DEFECTS OF MIDDLE AND PROXIMAL PARTS OF DOUBLE FIGURES

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