Repair of resurfacing soft tissue defect of hand with radial collateral artery polyfoliate perforator flap_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YU Fang ,  TANG Juyu , WU Panfeng , ZHOU Zhengbing , PANG Xiaoyang , ZENG Lei , XIAO Yongbing , PAN Ding , QING Liming , LIU Rui

Department of Hand and Microsurgery, Xiangya Hospital Central South University, Changsha Hunan, 410008, P.R.China;

Corresponding?author：

TANG Juyu, Email: tangjuyu7749@163.com

Keywords：

Perforator flap; polyfoliate flap; radial collateral artery; hand; wound repair

DOI：

10.7507/1002-1892.201902005

Video：

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Objective To explore the feasibility and effectiveness of radial collateral artery polyfoliate perforator flap in repair of resurfacing soft tissue defect of hand. Methods Between September 2017 and September 2018, the radial collateral artery polyfoliate perforator flaps were transplanted to repair 5 cases of two adjacent wounds of hand and wide or irregular wounds. All patients were male, aged from 27 to 52 years, with an average of 42.5 years. The time from injury to admission was 4 hours to 3 weeks, with an average of 7.3 days. Causes of injury included traffic accident in 2 cases, crushing injury in 2 cases, and paint injection injury in 1 case. The wounds were located at the dorsum of hand in 3 cases, the dorsum of finger in 1 case, and the thumb and thumb web in 1 case. The area of wound ranged from 8 cm×6 cm to 10 cm×8 cm. The area of skin flap ranged from 6.0 cm×3.0 cm to 11.0 cm×4.5 cm, all of which carried the posterior cutaneous nerve of the arm, and the donor site was closed directly. Results All flaps survived and healed by first intention. All patients were followed up 3-11 months (mean, 6.5 months). The patients were satisfied with the appearance of hands. The flaps were not bulky, and the color and texture were similar to the hand. There was only linear scar in the donor site, no radial nerve injury occurred, and elbow joint function was not affected. One patient underwent finger-splitting and skin flap thinning at 6 months after operation. Conclusion The radial collateral artery polyfoliate perforator flap is a good method for repairing two adjacent wounds and wide or irregular wounds of hand.

Citation： YU Fang, TANG Juyu, WU Panfeng, ZHOU Zhengbing, PANG Xiaoyang, ZENG Lei, XIAO Yongbing, PAN Ding, QING Liming, LIU Rui. Repair of resurfacing soft tissue defect of hand with radial collateral artery polyfoliate perforator flap. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(6): 721-725. doi: 10.7507/1002-1892.201902005 Copy

1.	朱慶生, 李華林, 吳克儉, 等. 臂外側皮瓣游離移植修復手部皮膚缺損. 中國修復重建外科雜志, 1995, 9(4): 261.
2.	芮永軍, 李向榮, 張全榮, 等. 上臂外側皮瓣的臨床應用. 中國修復重建外科雜志, 1994, 8(1): 52.
3.	Haas F, Rappl T, Koch H, et al. Free osteocutaneous lateral arm flap: anatomy and clinical applications. Microsurgery, 2003, 23(2): 87-95.
4.	Chen HC, el-Gammal TA. The lateral arm fascial free flap for resurfacing of the hand and fingers. Plast Reconstr Surg, 1997, 99(2): 454-459.
5.	劉宏君, 張文忠, 王天亮, 等. 游離上臂外側皮瓣修復手部熱壓傷 15 例. 中華整形外科雜志, 2016, 32(5): 337-339.
6.	Song R, Song Y, Yu Y, et al. The upper arm free flap. Clin Plast Surg, 1982, 9(1): 27-35.
7.	唐舉玉, 李康華, 廖前德, 等. 穿支皮瓣移植修復四肢軟組織缺損 108 例. 中華顯微外科雜志, 2010, 33(3): 186-189.
8.	唐舉玉. 特殊形式穿支皮瓣的臨床應用教程. 中華顯微外科雜志, 2013, 36(2): 201-205.
9.	Hwang K, Lee WJ, Jung CY, et al. Cutaneous perforators of the upper arm and clinical applications. J Reconstr Microsurg, 2005, 21(7): 463-469.
10.	Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg, 1984, 12(6): 489-500.
11.	Brandt KE, Khouri RK. The lateral arm/proximal forearm flap. Plast Reconstr Surg, 1993, 92(6): 1137-1143.
12.	Kuek LB, Chuan TL. The extended lateral arm flap: a new modification. J Reconstr Microsurg, 1991, 7(3): 167-173.
13.	陳勇, 楊旭東, 李威, 等. 游離延展上臂外側皮瓣修復洞穿性頰部缺損一例. 中國修復重建外科雜志, 2012, 26(4): 508-510.
14.	葉曙明, 滕曉峰, 陳宏, 等. 游離上臂外側分葉皮瓣修復手部多創面皮膚缺損的臨床應用. 中國修復重建外科雜志, 2016, 30(4): 444-446.
15.	胡浩良, 李學淵, 周曉玲, 等. 個性化設計游離上臂外側穿支皮瓣修復手部不規則皮膚軟組織缺損. 中國修復重建外科雜志, 2015, 29(12): 1510-1514.
16.	Carr LW, Brooke SM, Johnson TS, et al. Reexploring the anatomy of the distal humerus for its role in providing vascularized bone. Plast Reconstr Surg Glob Open, 2018, 6(1): e1636.
17.	李學淵, 黃劍, 胡浩良, 等. 游離上臂外側組合穿支皮瓣修復上肢較大面積皮膚軟組織缺損. 中華手外科雜志, 2015, 31(6): 418-420.
18.	李國棟, 徐永清, 何曉清, 等. 數字化技術在外側腓腸淺動脈穿支皮瓣修復手部中小創面中的應用研究. 中國修復重建外科雜志, 2017, 31(5): 564-569.
19.	唐舉玉, 卿黎明, 賀繼強, 等. 數字化技術輔助旋股外側動脈降支分葉穿支皮瓣設計的初步應用. 中華顯微外科雜志, 2016, 39(2): 123-126.

1. 朱慶生, 李華林, 吳克儉, 等. 臂外側皮瓣游離移植修復手部皮膚缺損. 中國修復重建外科雜志, 1995, 9(4): 261.
2. 芮永軍, 李向榮, 張全榮, 等. 上臂外側皮瓣的臨床應用. 中國修復重建外科雜志, 1994, 8(1): 52.
3. Haas F, Rappl T, Koch H, et al. Free osteocutaneous lateral arm flap: anatomy and clinical applications. Microsurgery, 2003, 23(2): 87-95.
4. Chen HC, el-Gammal TA. The lateral arm fascial free flap for resurfacing of the hand and fingers. Plast Reconstr Surg, 1997, 99(2): 454-459.
5. 劉宏君, 張文忠, 王天亮, 等. 游離上臂外側皮瓣修復手部熱壓傷 15 例. 中華整形外科雜志, 2016, 32(5): 337-339.
6. Song R, Song Y, Yu Y, et al. The upper arm free flap. Clin Plast Surg, 1982, 9(1): 27-35.
7. 唐舉玉, 李康華, 廖前德, 等. 穿支皮瓣移植修復四肢軟組織缺損 108 例. 中華顯微外科雜志, 2010, 33(3): 186-189.
8. 唐舉玉. 特殊形式穿支皮瓣的臨床應用教程. 中華顯微外科雜志, 2013, 36(2): 201-205.
9. Hwang K, Lee WJ, Jung CY, et al. Cutaneous perforators of the upper arm and clinical applications. J Reconstr Microsurg, 2005, 21(7): 463-469.
10. Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg, 1984, 12(6): 489-500.
11. Brandt KE, Khouri RK. The lateral arm/proximal forearm flap. Plast Reconstr Surg, 1993, 92(6): 1137-1143.
12. Kuek LB, Chuan TL. The extended lateral arm flap: a new modification. J Reconstr Microsurg, 1991, 7(3): 167-173.
13. 陳勇, 楊旭東, 李威, 等. 游離延展上臂外側皮瓣修復洞穿性頰部缺損一例. 中國修復重建外科雜志, 2012, 26(4): 508-510.
14. 葉曙明, 滕曉峰, 陳宏, 等. 游離上臂外側分葉皮瓣修復手部多創面皮膚缺損的臨床應用. 中國修復重建外科雜志, 2016, 30(4): 444-446.
15. 胡浩良, 李學淵, 周曉玲, 等. 個性化設計游離上臂外側穿支皮瓣修復手部不規則皮膚軟組織缺損. 中國修復重建外科雜志, 2015, 29(12): 1510-1514.
16. Carr LW, Brooke SM, Johnson TS, et al. Reexploring the anatomy of the distal humerus for its role in providing vascularized bone. Plast Reconstr Surg Glob Open, 2018, 6(1): e1636.
17. 李學淵, 黃劍, 胡浩良, 等. 游離上臂外側組合穿支皮瓣修復上肢較大面積皮膚軟組織缺損. 中華手外科雜志, 2015, 31(6): 418-420.
18. 李國棟, 徐永清, 何曉清, 等. 數字化技術在外側腓腸淺動脈穿支皮瓣修復手部中小創面中的應用研究. 中國修復重建外科雜志, 2017, 31(5): 564-569.
19. 唐舉玉, 卿黎明, 賀繼強, 等. 數字化技術輔助旋股外側動脈降支分葉穿支皮瓣設計的初步應用. 中華顯微外科雜志, 2016, 39(2): 123-126.

Chinese Journal of Reparative and Reconstructive Surgery

Repair of resurfacing soft tissue defect of hand with radial collateral artery polyfoliate perforator flap

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