CLINICAL APPLICATION OF LATERAL ARM LOBULATED FLAPS TO REPAIR MULTIPLE SOFT TISSUE DEFECT OF HAND_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YEShuming ¹ , TENGXiaofeng ² , CHENHong ² ,  JINGJuehua ¹ , ZHANGJisen ¹

1. Department of Orthopaedics, the Second Affiliated Hospital of Anhui Medical University, Hefei Anhui, 236001, P. R. China;
2. Department of Hand Surgery, Ningbo No.6 Hospital;

Corresponding?author：

JINGJuehua, Email: jjhhu@sina.com

Keywords：

Lateral arm lobulated flap; Multiple soft tissue defects; Flap repair; Hand

DOI：

10.7507/1002-1892.20160089

Video：

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Objective To explore the effectiveness and operation of repairing multiple soft tissue defects in hands with lateral arm lobulated flaps. Method Between October 2013 and September 2015, 13 cases of multiple soft tissue defects in the hand with tendon or bone exposure were treated with lateral arm lobulated flaps. All patients were males with average age of 28 years (range, 23-45 years). Defects were caused by penetrating injury in 7 cases, traffic accident injury in 3 cases, and hot-crush injury in 3 cases. Six patients had skin defect of the left 2 fingers after opening finger amputation, and 7 patients had skin defect of the palm and the back after hand injury. The size of skin defects ranged from 6 cm×5 cm to 9 cm×6 cm. All patients underwent emergency debridement and two-stage repair; the duration from injury to operation was 5-9 days (mean, 7 days). The size of flap was 6 cm×5 cm-9 cm×6 cm. Results All flaps survived completely, with no vascular crisis. Primary healing was obtained at donor and recipient sites, and the grafted skin survived. All cases were followed up 3-24 months (mean, 12 months). The appearance and texture of the flaps were similar to those of adjacent skin. Bulky flap was observed in 4 cases, and second stage operation was performed to make the flap thinner at 3 months after operation. The sensation of flap reached S₃-S₄. Conclusions The lateral arm lobulated flap based on the radial collateral artery has constant vascular anatomy, easy-to-harvest, and large rotation angle. It is an effective procedure to repair small and medium size skin defects of the hand with satisfied texture and sensory recovery.

Citation： YEShuming, TENGXiaofeng, CHENHong, JINGJuehua, ZHANGJisen. CLINICAL APPLICATION OF LATERAL ARM LOBULATED FLAPS TO REPAIR MULTIPLE SOFT TISSUE DEFECT OF HAND. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(4): 444-446. doi: 10.7507/1002-1892.20160089 Copy

1.	趙志鋼, 王劍利, 魏海溫, 等. 毀損性手外傷急診修復與重建的方法選擇. 中華顯微外科雜志, 2013, 36(4) :395-397.
2.	金秀, 王濤, 蔣子平, 等. 四肢電燒傷創面的皮瓣修復. 中華顯微外科雜志, 2015, 38(2) :120-122.
3.	張丕紅, 張明華, 謝庭鴻, 等. 游離上臂外側穿支皮瓣修復手足部電燒傷創面. 中華燒傷雜志, 2015, 29(5) :424-426.
4.	梅良斌, 朱躍良, 王毅, 等. 游離上臂外側皮瓣修復手足皮膚缺損. 中華創傷骨科雜志, 2014, 16(4) :357-358.
5.	楊衛璽, 李春江, 王一兵, 等. 游離上臂外側皮瓣修復手部深度燒傷. 中華顯微外科雜志, 2010, 33(5) :436.
6.	高樹林, 曹艷, 唐永豐, 等. 臂外側下部游離皮瓣在手部創面修復中的應用. 中華顯微外科雜志, 2010, 33(2) :155-156.
7.	李贊, 喻建軍, 黃文孝, 等. 游離上臂外側皮瓣在頭頸腫瘤術后缺損修復的臨床應用. 組織工程與外科重建雜志, 2007, 3(2) :83-85.
8.	王彥生, 張輝, 沈勇, 等. 游離組織移植修復前臂軟組織缺損的臨床研究. 中華手外科雜志, 2014, 30(3) :203-205.
9.	孫廣峰, 魏在榮, 金文虎, 等. 擴張髂腹股溝超薄皮瓣修復手部前臂瘢痕. 中華手外科雜志, 2015, 31(1) :53-55.
10.	周福臨, 陳偉, 張毅, 等. 改良骨間背骨皮瓣修復手背皮膚合并掌骨缺損的臨床應用. 中華手外科雜志, 2014, 30(4) :305-306.
11.	周炎, 陳振兵, 瞿新叢, 等. 應用帶血管蒂皮瓣修復手背軟組織缺損. 中華手外科雜志, 2014, 30(4) :303-304.
12.	孟祥海, 王曉琳, 李學擁, 等. 復合皮移植修復燒傷功能部位創面療效評價. 中國修復重建外科雜志, 2012, 26(2) :219-222.
13.	莊加川, 李敏姣, 陳樂鋒, 等. 上臂內側游離皮瓣修復手部皮膚缺損的臨床應用. 中華手外科雜志, 2015, 31(3) :185-187.
14.	戚建武, 柴益銅, 王科杰, 等. 游離腹股溝皮瓣修復手部皮膚缺損. 中華手外科雜志, 2013, 29(5) :271-273.
15.	周曉, 芮永軍, 壽奎水, 等. 近節掌指背皮瓣修復指根部島狀皮瓣供區的臨床應用. 中華手外科雜志, 2012, 28(4) :221-223.
16.	Song R, Song Y, Yu Y, et al. The upper arm free flap. Clin Plast Surg, 1982, 9(1) :27-35.
17.	Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap:anatomy and clinical applications. Ann Plast Surg, 1984, 12(2) :489-500.
18.	孫瑞梅, 王金德, 李群, 等. 改良游離上臂外側皮瓣應用解剖研究. 中華耳鼻咽喉頭頸外科雜志, 2013, 48(1) :37-41.

1. 趙志鋼, 王劍利, 魏海溫, 等. 毀損性手外傷急診修復與重建的方法選擇. 中華顯微外科雜志, 2013, 36(4) :395-397.
2. 金秀, 王濤, 蔣子平, 等. 四肢電燒傷創面的皮瓣修復. 中華顯微外科雜志, 2015, 38(2) :120-122.
3. 張丕紅, 張明華, 謝庭鴻, 等. 游離上臂外側穿支皮瓣修復手足部電燒傷創面. 中華燒傷雜志, 2015, 29(5) :424-426.
4. 梅良斌, 朱躍良, 王毅, 等. 游離上臂外側皮瓣修復手足皮膚缺損. 中華創傷骨科雜志, 2014, 16(4) :357-358.
5. 楊衛璽, 李春江, 王一兵, 等. 游離上臂外側皮瓣修復手部深度燒傷. 中華顯微外科雜志, 2010, 33(5) :436.
6. 高樹林, 曹艷, 唐永豐, 等. 臂外側下部游離皮瓣在手部創面修復中的應用. 中華顯微外科雜志, 2010, 33(2) :155-156.
7. 李贊, 喻建軍, 黃文孝, 等. 游離上臂外側皮瓣在頭頸腫瘤術后缺損修復的臨床應用. 組織工程與外科重建雜志, 2007, 3(2) :83-85.
8. 王彥生, 張輝, 沈勇, 等. 游離組織移植修復前臂軟組織缺損的臨床研究. 中華手外科雜志, 2014, 30(3) :203-205.
9. 孫廣峰, 魏在榮, 金文虎, 等. 擴張髂腹股溝超薄皮瓣修復手部前臂瘢痕. 中華手外科雜志, 2015, 31(1) :53-55.
10. 周福臨, 陳偉, 張毅, 等. 改良骨間背骨皮瓣修復手背皮膚合并掌骨缺損的臨床應用. 中華手外科雜志, 2014, 30(4) :305-306.
11. 周炎, 陳振兵, 瞿新叢, 等. 應用帶血管蒂皮瓣修復手背軟組織缺損. 中華手外科雜志, 2014, 30(4) :303-304.
12. 孟祥海, 王曉琳, 李學擁, 等. 復合皮移植修復燒傷功能部位創面療效評價. 中國修復重建外科雜志, 2012, 26(2) :219-222.
13. 莊加川, 李敏姣, 陳樂鋒, 等. 上臂內側游離皮瓣修復手部皮膚缺損的臨床應用. 中華手外科雜志, 2015, 31(3) :185-187.
14. 戚建武, 柴益銅, 王科杰, 等. 游離腹股溝皮瓣修復手部皮膚缺損. 中華手外科雜志, 2013, 29(5) :271-273.
15. 周曉, 芮永軍, 壽奎水, 等. 近節掌指背皮瓣修復指根部島狀皮瓣供區的臨床應用. 中華手外科雜志, 2012, 28(4) :221-223.
16. Song R, Song Y, Yu Y, et al. The upper arm free flap. Clin Plast Surg, 1982, 9(1) :27-35.
17. Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap:anatomy and clinical applications. Ann Plast Surg, 1984, 12(2) :489-500.
18. 孫瑞梅, 王金德, 李群, 等. 改良游離上臂外側皮瓣應用解剖研究. 中華耳鼻咽喉頭頸外科雜志, 2013, 48(1) :37-41.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF LATERAL ARM LOBULATED FLAPS TO REPAIR MULTIPLE SOFT TISSUE DEFECT OF HAND

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