The regularity of sensory recovery after wound repair on the wrist and back of hand with anterolateral femoral flap without nerve anastomosis

Zhou Yao; Ju Jihui; Tang Linfeng; Wang Kai; Zhou Rong; Guo Liping; Yang Liang

doi:10.3760/cma.j.cn501120-20211014-00350

Volume 38 Issue 11

Nov. 2022

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2022 > 38(11): 1040-1046

Zhou Y,Ju JH,Tang LF,et al.The regularity of sensory recovery after wound repair on the wrist and back of hand with anterolateral femoral flap without nerve anastomosis[J].Chin J Burns Wounds,2022,38(11):1040-1046.DOI: 10.3760/cma.j.cn501120-20211014-00350.

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The regularity of sensory recovery after wound repair on the wrist and back of hand with anterolateral femoral flap without nerve anastomosis

doi: 10.3760/cma.j.cn501120-20211014-00350

1.
Changshu Hai Yu Health Centre, Changshu 215500, China
2.
Suzhou Ruihua Orthopedic Hospital, Suzhou 215104, China

Funds:

Health Talents Program of Suzhou Gusu District 2020075

Suzhou MinSheng Science and Technology Project SS202092

Special Project of Health Science and Education on Diagnosis and Treatment Technology of Clinical Key Disease Species of Suzhou LCZX202026

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Corresponding author: Ju Jihui, Email: jjh2006@263.net
Received Date: 2021-10-14

Abstract

Abstract

Objective To investigate the regularity of sensory recovery after repairing the wounds on the wrist and back of hand with anterolateral femoral flap without nerve anastomosis. Methods A cross-sectional study was conducted. From January 2018 to December 2020, patients who underwent free anterolateral femoral flaps without nerve anastomosis to repair wounds on the wrist and back of hand and met the inclusion criteria in Changshu Hai Yu Health Centre and Suzhou Ruihua Orthopedic Hospital were included in this study. Depending on the time interval between the day of the patient's surgery and the day of the cross-sectional survey, 80 patients were divided into 6-month group (15 males and 5 females, aged 22-63 years), 12-month group (16 males and 4 females, aged 21-65 years), 18-month group (15 males and 5 females, aged 25-61 years), and 24-month group (14 males and 6 females, aged 20-65 years), with 20 patients in each group. The area of skin and soft tissue defects after debridement ranged from 6.0 cm×4.5 cm to 18.0 cm×9.0 cm. Anterolateral femoral flaps were cut with areas of 7 cm×5 cm to 20 cm×10 cm and a thickness of 1.0 to 2.5 cm. Each transplanted flap was divided into A (proximal), B/D (bilateral), C (distal), and E (central) regions. The pain sensation, touch sensation, cold sensation, warmth sensation, and two-point discrimination (2-PD) in the aforementioned five regions and the differences in the five senses of the whole flap were tested and compared. Data were statistically analyzed with one-way analysis of variance, Fisher's exact probability test, chi-square test, or McNemar test. Results In A region of anterolateral femoral flap without nerve anastomosis, compared with those in 6-month group, the pain sensation, touch sensation, cold sensation, and warmth sensation of flap of patients in 12-month group were significantly recovered (with χ ² values of 10.10, 14.55, 12.13, and 4.29, respectively, P<0.05 or P<0.01); compared with that in 12-month group, the warmth sensation of flap of patients in 18-month group recovered significantly ( χ ²=5.23, P<0.05). In B region, compared with those in 6-month group, the pain sensation, touch sensation, and cold sensation of flap of patients in 12-month group recovered significantly (with χ ² values of 5.58, 3.96, and 4.29, respectively, P<0.05); compared with those in 12-month group, the pain sensation, touch sensation, cold sensation, and warmth sensation of flap of patients in 18-month group recovered significantly (with χ ² values of 5.58, 3.96, 7.03, and 12.38, respectively, P<0.05 or P<0.01). In C region, compared with that in 6-month group, the pain sensation of flap of patients in 12-month group recovered significantly ( χ ²=4.80, P<0.05); Compared with that in 12-month group, the warmth sensation of flap of patients in 18-month group recovered significantly ( χ ²=10.16, P<0.01). In D region, compared with those in 6-month group, the pain sensation, touch sensation, and cold sensation of flap of patients in 12-month group recovered significantly (with χ ² values of 5.58, 4.29, and 3.96, respectively, P<0.05); compared with those in 12-month group, the pain sensation, touch sensation, cold sensation, and warmth sensation of flap of patients in 18-month group recovered significantly (with χ ² values of 5.58, 4.29, 3.96, and 10.10, respectively, P<0.05 or P<0.01). In E region, compared with that in 6-month group, the cold sensation of flap of patients in 12-month group recovered significantly ( χ ²=4.80, P<0.05); compared with those in 12-month group, the pain sensation, touch sensation, and warmth sensation of flap of patients in 18-month group recovered significantly (with χ ² values of 6.47, 4.91, and 9.23, respectively, P<0.05 or P<0.01). The five senses in the 5 regions of flap of patients in 24-month group were similar to those in 18-month group ( P>0.05). The recovery of 2-PD in the 5 regions of flap of patients was similar between the two adjacent groups ( P>0.05). In 12-month group, the recoveries of pain sensation, touch sensation, and cold sensation of flap of patients in A region were better than those in the other 4 regions ( P<0.05 or P<0.01), the recovery of warmth sensation was better than that of B region, C region, and E region ( P<0.05 or P<0.01); in 18-month group, the recovery of pain sensation, touch sensation, cold sensation, and warmth sensation of flap of patients in A region of was better than those in area C region ( P<0.05). Compared with those in 6-month group, the pain sensation, touch sensation, and cold sensation of the whole flap of patients in 12-month group recovered significantly (with χ ² values of 7.62, 7.03, and 5.58, respectively, P<0.05 or P<0.01). Compared with the 12-month group in which 10, 11, 10, and 4 patients had a recovery of pain, touch sensation, cold sensation, and warmth sensation in the whole flap, the 18-month group had significantly more patients with sensations recovered, which were 17, 17, 16, and 14, respectively (with χ ² values of 5.58, 4.29, 3.96, and 10.10, respectively, P<0.05 or P<0.01). The five senses of the whole flap of patients in 24-month group were similar to those in 18-month group ( P>0.05). Conclusions In the anterolateral femoral flap without nerve anastomosis for repairing wounds on the wrist and back of hand, the sensation gradually recovered from the proximal end to the distal end. The sensation of touch, pain, and cold began to recover from 6 months after operation, and entered the stable recover period at 18 months after operation. Warmth sensation began to recover from 12 months after operation, and entered the stable recovery period at 18 months after operation. The 2-PD of most flaps was still not recovered 2-year after operation.
- Surgical flap,
- Microsurgery,
- Hand,
- Feeling,
- Wrist,
- Nerve anastomosis,
- Wound repair

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The regularity of sensory recovery after wound repair on the wrist and back of hand with anterolateral femoral flap without nerve anastomosis

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The regularity of sensory recovery after wound repair on the wrist and back of hand with anterolateral femoral flap without nerve anastomosis

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