Email Alerts
RSS
Volume 38 Issue 11
Nov.  2022
Turn off MathJax
Article Contents
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.
Citation: 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.
shu

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

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

     

    • FullText(HTML)
  • loading
    • References(29)
  • [1]
    唐茂林,刘元波.穿支皮瓣的解剖学研究进展[J].中华整形外科杂志,2018,34(9):785-790.DOI: 10.3760/cma.j.issn.1009-4598.2018.09.022.
    [2]
    周征兵, 唐举玉, 吴攀峰, 等. 双侧旋股外侧动脉降支穿支皮瓣组合移植治疗上肢大面积组织缺损[J].中华手外科杂志,2019,35(3):183-185.DOI: 10.3760/cma.j.issn.1005-054X.2019.03.008.
    [3]
    顾荣, 王海文, 江新民, 等. 髂腹股沟联体穿支皮瓣移植修复上肢较大面积皮肤缺损[J].中华显微外科杂志,2017,40(5):433-437. DOI: 10.3760/cma.j.issn.1001-2036.2017.05.005.
    [4]
    金光哲, 巨积辉, 熊胜, 等. 单叶或双叶带阔筋膜的股前外侧皮瓣在手足背皮肤肌腱缺损中的应用[J].中华手外科杂志,2019,35(4):241-243. DOI: 10.3760/cma.j.issn.1005-054X.2019.04.001.
    [5]
    刘胜哲, 巨积辉, 柳志锦, 等. 串并联双侧股前外侧超长穿支皮瓣修复四肢大面积创面的临床效果[J].中华烧伤杂志,2021,37(3):250-256. DOI: 10.3760/cma.j.cn501120-20200226-00096.
    [6]
    柳志锦, 巨积辉, 刘胜哲, 等. 股前外侧区双叶穿支皮瓣的血供方式及临床应用[J].中华骨科杂志,2021,41(4):211-218. DOI: 10.3760/cma.j.cn121113-20200415-00259.
    [7]
    宋达疆, 李赞, 周晓, 等. 分叶股前外侧穿支皮瓣修复口腔复杂洞穿缺损[J].中华整形外科杂志,2019,35(10):978-985. DOI: 10.3760/cma.j.issn.1009-4598.2019.10.006.
    [8]
    巨积辉, 周荣, 刘跃飞, 等. 超长股外侧区内增压型穿支皮瓣修复足踝部创面的临床效果[J].中华烧伤杂志,2019,35(7):495-500. DOI: 10.3760/cma.j.issn.1009-2587.2019.07.004.
    [9]
    邢培朋, 郭海娜, 狄海萍, 等. 游离股前外侧皮瓣联合动脉血管重建修复腕部高压电烧伤创面的临床效果[J].中华烧伤杂志,2020,36(6):419-425. DOI: 10.3760/cma.j.cn501120-20200219-00067.
    [10]
    刘会仁, 刘家寅. 对《MBCMA股前外侧皮瓣临床应用指南(2016征求意见稿)》的浅见[J].中华显微外科杂志,2017,40(2):205-206. DOI: 10.3760/cma.j.issn.1001-2036.2017.02.031.
    [11]
    唐举玉, 魏在荣, 张世民, 等. 穿支皮瓣的临床应用原则专家共识[J].中国临床解剖学杂志,2016(1):4-5. DOI: 10.13418/j.issn.1001-165x.2016.01.002.
    [12]
    徐磊, 巨积辉, 侯瑞兴, 等. 双足第二趾胫侧皮肤两点分辨觉的比较研究及其临床意义[J].中华手外科杂志,2016,32(6):460-462. DOI: 10.3760/cma.j.issn.1005-054X.2016.06.027.
    [13]
    吴昌盛, 潘振宇, 李平华, 等. 缝合神经的游离股前外侧皮瓣修复前足皮肤缺损皮瓣感觉恢复情况的中期随访[J].中华显微外科杂志,2018,41(4):371-373. DOI: 10.3760/cma.j.issn.1001-2036.2018.04.014.
    [14]
    周荣, 巨积辉, 唐林峰, 等. 带感觉神经的股前外侧穿支皮瓣修复足底皮肤软组织缺损的临床效果[J].中华烧伤杂志,2021,37(5):453-459. DOI: 10.3760/cma.j.cn501120-20200309-00136.
    [15]
    葛占洲, 陈秀民, 李晓良, 等. 应用有感觉功能的股前外侧穿支皮瓣修复足踝部创面[J].中华显微外科杂志,2019,42(4):385-388. DOI: 10.3760/cma.j.issn.1001-2036.2019.04.018.
    [16]
    李有斌, 刘少华, 丁治红, 等. 带感觉神经的股前外侧穿支皮瓣修复足底软组织缺损九例[J].中华显微外科杂志,2021,44(2):194-197. DOI: 10.3760/cma.j.cn441206-20200419-00207.
    [17]
    胡孔和, 吴强, 靳安民, 等. 神经端侧吻合重建游离皮瓣感觉功能的临床效果[J].中华显微外科杂志,2012,35(3):237-239. DOI: 10.3760/cma.j.issn.1001-2036.2012.03.025.
    [18]
    杨何平, 张洪武, 杨书雄, 等. 带感觉神经与失神经的股前外侧穿支皮瓣在头颈部感觉重建的对比研究[J].中华显微外科杂志,2016,39(3):225-229. DOI: 10.3760/cma.j.issn.1001-2036.2016.03.005.
    [19]
    刘芳, 常增林. 失神经皮瓣移植术后感觉神经再生的研究[J].中国现代医学杂志,2002,12(7):28-31. DOI: 10.3969/j.issn.1005-8982.2002.07.011.
    [20]
    贺倩茹, 丁斐. 周围神经趋化性再生研究新进展[J].解剖学杂志,2021,44(1):1-6. DOI: 10.3969/j.issn.1001-1633.2021.01.001.
    [21]
    肖飞鹏, 柳志锦, 刘胜哲, 等. 综合评价量表在股前外侧皮瓣修复术后疗效评价中的应用[J].中国美容整形外科杂志,2021,32(6):348-351. DOI: 10.3969/j.issn.1673-7040.2021.06.010.
    [22]
    唐举玉, 李康华, 谢松林, 等. 股前外侧皮瓣修复足跟大面积软组织缺损的感觉重建探讨[J].中华显微外科杂志,2012,35(4):267-271,后插1. DOI: 10.3760/cma.j.issn.1001-2036.2012.04.002.
    [23]
    牟勇, 黎路根, 胡春兰, 等. 削薄分叶股前外侧穿支皮瓣修复四肢复杂软组织缺损[J].中华显微外科杂志,2019,42(3):218-222. DOI: 10.3760/cma.j.issn.1001-2036.2019.03.003.
    [24]
    HastingsH. Dual innervated index to thumb cross finger or island flap reconstruction[J]. Microsurgery, 1987,8(3):168-172. DOI: 10.1002/micr.1920080312.
    [25]
    Torres-Ortíz ZermeñoCA, López MendozaJ. Aesthetic and functional outcomes of the innervated and thinned anterolateral thigh flap in reconstruction of upper limb defects[J]. Plast Surg Int, 2014,2014:489012. DOI: 10.1155/2014/489012.
    [26]
    吴包金, 江华. 失神经皮瓣移植感觉功能恢复的研究进展[J].中华整形外科杂志,2004,20(3):231-233. DOI: 10.3760/j.issn:1009-4598.2004.03.022.
    [27]
    沈余明, 覃凤均, 杜伟力, 等. 濒临截肢四肢高压电烧伤患者的保肢策略[J].中华烧伤杂志,2019,35(11):776-783. DOI: 10.3760/cma.j.issn.1009-2587.2019.11.003.
    [28]
    陈毅, 林平, 吴咏军, 等. 神经生长因子和第10号染色体同源丢失性磷酸酶-张力蛋白基因双基因修饰骨髓间充质干细胞促进周围神经再生[J].中华手外科杂志,2020,36(4):290-295. DOI: 10.3760/cma.j.cn311653-20190822-00233.
    [29]
    丁文龙, 温蔚, 谢志新. bFGF对同种异体神经移植后周围神经再生的影响[J].解剖学杂志,2002,25(2):141-145. DOI: 10.3969/j.issn.1001-1633.2002.02.010.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (2293) PDF downloads(20) Cited by()
    Proportional views
    Related

    Copyright © Chinese Journal of Burns京ICP备07035254号-14

    E-mail：shaoshangzazhi@163.com

    Website：https://zhsszz.xml-journal.net/

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return