Application of free superficial palmar branch of radial artery flap in repairing of soft tissue defect of fingers_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANG Liangku ¹ , XU Yuben ¹ , LI Peng ¹ , XIA Lei ¹ , TIAN Zhao ¹ , LU Meng ¹ ,  XU Tao ²

1. The Second Department of Hand Surgery, Red Cross Hospital Affiliated to Medical School of Xi’an Jiao Tong University, Xi’an Shaanxi, 710054, P.R.China;
2. Department of Anesthesia, Red Cross Hospital Affiliated to Medical School of Xi’an Jiao Tong University, Xi’an Shaanxi, 710054, P.R.China;

Corresponding?author：

XU Tao, Email: xutao19850315@163.com

Keywords：

Superficial palmar branch of the radial artery; perforators flap; finger; soft tissue defect; wound repair

DOI：

10.7507/1002-1892.201801040

Video：

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ObjectiveTo evaluate the surgical technique and the effectiveness of the free superficial palmar branch of the radial artery flap to repair soft tissue defect of fingers.MethodsBetween June 2014 and June 2017, 10 cases (10 fingers) of soft tissue defects of fingers were repaired with the free superficial palmar branch of the radial artery flaps. There were 8 males and 2 females with an average age of 29.8 years (range, 23-42 years). The causes of injury included the chainsaw cutting injury in 6 cases, the machine crush injury in 2 cases, and the glass scratching in 2 cases. The time from injury to admission was 1-8 hours with an average of 3 hours. The locations were the volar of the middle of index finger in 3 cases, the volar of the distal of index finger in 1 case, the volar of the distal of middle finger in 3 cases, the ulnar side of distal interphalangeal joint of ring finger in 1 case, and the volar of the distal of the little finger in 2 cases. The area of soft tissue defect ranged from 1.8 cm×0.9 cm to 2.8 cm×2.1 cm, and the area of flap ranged from 2.0 cm×1.0 cm to 3.0 cm×2.3 cm. The donor sites were sutured directly.ResultsAll flaps survived after operation, and the wounds healed by first intention. The incisions of donor site also healed by first intention with a linear scar. All cases were followed up 6-12 months (mean, 9 months). The appearance and texture of the flaps were satisfactory. The pain sensation, warm sensation, and touch sensation of the flap recovered. At last follow-up, the two-point discrimination of the flap was 6-13 mm (mean, 7.5 mm). According to the assessment of the upper limb function issued by tha Hand Surgery Society of Chinese Medical Association, the results were graded as excellent in 8 cases and good in 2 cases.ConclusionThe free superficial palmar branch of the radial artery flap is easy to harvest and anastomose and has small injury. It is an ideal method in repairing of soft tissue defects of fingers.

Citation： HUANG Liangku, XU Yuben, LI Peng, XIA Lei, TIAN Zhao, LU Meng, XU Tao. Application of free superficial palmar branch of radial artery flap in repairing of soft tissue defect of fingers. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(7): 955-958. doi: 10.7507/1002-1892.201801040 Copy

1.	Chen C, Tang P, Zhang X. Sensory reconstruction of a finger pulp defect using a dorsal homodigital island flap. Plast Reconstr Surg, 2012, 130(5): 1077-1086.
2.	肖建林, 廖前德, 戴順平, 等. 橈動脈掌淺支腕橫紋皮瓣微創修復手部軟組織缺損. 臨床骨科雜志, 2016, 19(6): 713-715.
3.	尚修超, 張乃臣, 劉宏君, 等. 游離橈動脈掌淺支皮瓣修復手指軟組織缺損. 中華手外科雜志, 2015, 31(1): 77.
4.	Kamei K, Ide Y, Kimura T. A new free thenar flap. Plast Reconstr Surg, 1993, 92(7): 1380-1384.
5.	Sakai S. Free flap from the flexor aspect of the wrist for resurfacing defects of the hand and fingers. Plast Reconstr Surg, 2003, 111(4): 1412-1420.
6.	鄭大偉, 黎章燦, 曹廣超, 等. 多種類型的橈動脈掌淺支腕橫紋部游離皮瓣修復手指復合軟組織缺損. 中華顯微外科雜志, 2016, 39(1): 12-16.
7.	潘達德, 顧玉東, 侍德. 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.	梁文勇, 曾文超, 紀林善, 等. 脛后動脈穿支皮瓣游離移植修復手部軟組織缺損的臨床效果. 中國醫師雜志, 2016, 18(4): 616-618.
9.	Okochi M, Saito M, Ueda K. Simple and easy reconstruction of nail matrix lesion using lateral finger flap after excision of digital mucous cyst. Case Reports Plast Surg Hand Surg, 2016, 3(1): 16-19.
10.	芮永軍, 張雁, 楊紅, 等. 術前不同定位方法在股前外側穿支皮瓣應用的對比分析. 中華顯微外科雜志, 2015, 38(1): 33-37.
11.	莫勇軍, 譚海濤, 楊克勤, 等. 3D 技術在足趾微型皮瓣移植修復拇和手指缺損的應用. 中華顯微外科雜志, 2015, 38(1): 294-297.
12.	Zheng DW, Li ZC, Sun F, et al. Use of a distal ulnar artery perforator-based bilobed free flap for repairing complex digital defects. J Hand Surg (Am), 2014, 39(11): 2235-2242.
13.	程超, 李梓瑞, 劉海波, 等. 游離橈動脈掌淺支腕橫紋皮瓣修復手指軟組織半環形缺損. 實用手外科雜志, 2016, 30(1): 94-95.
14.	14 張敬良, 雷彥文, 宋君, 等. 手部組織缺損修復方法的個性化路徑式選擇. 中華顯微外科雜志, 2013, 36(4): 343-347.
15.	白輝凱, 謝振軍, 趙國紅, 等. 應用游離尺動脈腕上皮支皮瓣修復手部小面積皮膚缺損. 中華手外科雜志, 2017, (2):153-154.
16.	尚修超, 張乃臣, 劉宏君, 等. 游離橈動脈掌淺支皮瓣修復手指軟組織缺損. 中華手外科雜志, 2015, 31(1): 77.
17.	強力, 薛明宇, 卜凡玉, 等. 游離腕橫紋嵌合皮瓣修復手指復合組織缺損八例. 中華顯微外科雜志, 2017, 40(4): 371-373.
18.	Omokawa S, Ryu J, Tang JB, et al. Vascular and neural anatomy of the thenar area of the hand: its surgical applications. Plast Reconstr Surg, 1997, 99(1): 116-121.
19.	張亞斌, 李會曉, 夏利鋒, 等. 橈動脈腕橫紋穿支皮瓣的解剖及臨床應用. 中華顯微外科雜志, 2015, 38(5): 479-481.
20.	Yang IW, Kim JS, Lee DC, et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. J Reconstr Microsurg, 2010, 26(8): 529-538.
21.	Simsek T, Engin MS, Aslan O, et al. Finger pulp reconstruction with free dorsoulnar perforator (DUAP) flap. J Reconstr Microsurg, 2011, 27(9): 543-549.

1. Chen C, Tang P, Zhang X. Sensory reconstruction of a finger pulp defect using a dorsal homodigital island flap. Plast Reconstr Surg, 2012, 130(5): 1077-1086.
2. 肖建林, 廖前德, 戴順平, 等. 橈動脈掌淺支腕橫紋皮瓣微創修復手部軟組織缺損. 臨床骨科雜志, 2016, 19(6): 713-715.
3. 尚修超, 張乃臣, 劉宏君, 等. 游離橈動脈掌淺支皮瓣修復手指軟組織缺損. 中華手外科雜志, 2015, 31(1): 77.
4. Kamei K, Ide Y, Kimura T. A new free thenar flap. Plast Reconstr Surg, 1993, 92(7): 1380-1384.
5. Sakai S. Free flap from the flexor aspect of the wrist for resurfacing defects of the hand and fingers. Plast Reconstr Surg, 2003, 111(4): 1412-1420.
6. 鄭大偉, 黎章燦, 曹廣超, 等. 多種類型的橈動脈掌淺支腕橫紋部游離皮瓣修復手指復合軟組織缺損. 中華顯微外科雜志, 2016, 39(1): 12-16.
7. 潘達德, 顧玉東, 侍德. 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. 梁文勇, 曾文超, 紀林善, 等. 脛后動脈穿支皮瓣游離移植修復手部軟組織缺損的臨床效果. 中國醫師雜志, 2016, 18(4): 616-618.
9. Okochi M, Saito M, Ueda K. Simple and easy reconstruction of nail matrix lesion using lateral finger flap after excision of digital mucous cyst. Case Reports Plast Surg Hand Surg, 2016, 3(1): 16-19.
10. 芮永軍, 張雁, 楊紅, 等. 術前不同定位方法在股前外側穿支皮瓣應用的對比分析. 中華顯微外科雜志, 2015, 38(1): 33-37.
11. 莫勇軍, 譚海濤, 楊克勤, 等. 3D 技術在足趾微型皮瓣移植修復拇和手指缺損的應用. 中華顯微外科雜志, 2015, 38(1): 294-297.
12. Zheng DW, Li ZC, Sun F, et al. Use of a distal ulnar artery perforator-based bilobed free flap for repairing complex digital defects. J Hand Surg (Am), 2014, 39(11): 2235-2242.
13. 程超, 李梓瑞, 劉海波, 等. 游離橈動脈掌淺支腕橫紋皮瓣修復手指軟組織半環形缺損. 實用手外科雜志, 2016, 30(1): 94-95.
14. 14 張敬良, 雷彥文, 宋君, 等. 手部組織缺損修復方法的個性化路徑式選擇. 中華顯微外科雜志, 2013, 36(4): 343-347.
15. 白輝凱, 謝振軍, 趙國紅, 等. 應用游離尺動脈腕上皮支皮瓣修復手部小面積皮膚缺損. 中華手外科雜志, 2017, (2):153-154.
16. 尚修超, 張乃臣, 劉宏君, 等. 游離橈動脈掌淺支皮瓣修復手指軟組織缺損. 中華手外科雜志, 2015, 31(1): 77.
17. 強力, 薛明宇, 卜凡玉, 等. 游離腕橫紋嵌合皮瓣修復手指復合組織缺損八例. 中華顯微外科雜志, 2017, 40(4): 371-373.
18. Omokawa S, Ryu J, Tang JB, et al. Vascular and neural anatomy of the thenar area of the hand: its surgical applications. Plast Reconstr Surg, 1997, 99(1): 116-121.
19. 張亞斌, 李會曉, 夏利鋒, 等. 橈動脈腕橫紋穿支皮瓣的解剖及臨床應用. 中華顯微外科雜志, 2015, 38(5): 479-481.
20. Yang IW, Kim JS, Lee DC, et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. J Reconstr Microsurg, 2010, 26(8): 529-538.
21. Simsek T, Engin MS, Aslan O, et al. Finger pulp reconstruction with free dorsoulnar perforator (DUAP) flap. J Reconstr Microsurg, 2011, 27(9): 543-549.

Chinese Journal of Reparative and Reconstructive Surgery

Application of free superficial palmar branch of radial artery flap in repairing of soft tissue defect of fingers

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