Volume 39 Issue 6
Jun.  2023
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Cheng HY,Ju JH,Zhao Q,et al.Effects of free superficial peroneal artery perforator flap in repairing small and medium-sized thermal crush injury wounds in the hand[J].Chin J Burns Wounds,2023,39(6):546-551.DOI: 10.3760/cma.j.cn501225-20220623-00256.
Citation: Cheng HY,Ju JH,Zhao Q,et al.Effects of free superficial peroneal artery perforator flap in repairing small and medium-sized thermal crush injury wounds in the hand[J].Chin J Burns Wounds,2023,39(6):546-551.DOI: 10.3760/cma.j.cn501225-20220623-00256.

Effects of free superficial peroneal artery perforator flap in repairing small and medium-sized thermal crush injury wounds in the hand

doi: 10.3760/cma.j.cn501225-20220623-00256
Funds:

Suzhou Medical and Health Science and Technology Innovation-Applied Basic Research Program SKJY2021021

Suzhou Key Medical Discipline SZXK202127

More Information
  • Corresponding author: Zhao Qiang, Email: zq1025422@163.com
  • Received Date: 2022-06-23
  •   Objective   To investigate the surgical methods and clinical effects of free superficial peroneal artery perforator flap in repairing small and medium-sized thermal crush injury wounds in the hand.   Methods   A retrospective observational study was conducted. From August 2018 to December 2021, 12 patients (19 wounds) with small and medium-sized thermal crush injury in the hand who met the inclusion criteria were hospitalized in Suzhou Ruihua Orthopaedic Hospital, including 5 males and 7 females, aged from 30 to 54 years. The area of the wound was from 2.5 cm×2.0 cm to 14.0 cm×3.5 cm, and all the wounds were repaired by using free superficial peroneal artery perforator flaps from lower leg on one side (including single flap, multiple flaps, and multiple flaps with one pedicle resected from the same donor site). The area of the flap was from 3.5 cm×3.0 cm to 16.0 cm×4.0 cm. The wound in the donor site was sutured directly. The vascular crisis and survival of the flap were observed after operation. The texture, appearance, color, hyperpigmentation, sensation, and two-point discrimination of the flap repaired area were followed up, as well as the hyperplasia of scar and pain condition in the donor and recipient sites. At the last follow-up, the curative effect of flap repair was evaluated by the comprehensive evaluation scale, and the extension and flexion functions of the reserved digital joint were evaluated by the total active movement systematic evaluation method recommended by American Academy for Surgery of Hand.   Results   One flap developed arterial crisis on the first day after operation but survived after timely exploration. The other 18 flaps survived successfully after operation. Follow-up of 4 to 24 months after operation showed good texture and appearance in the flap repaired area; the color of the flap repaired area was similar to that of the normal skin around the recipient site, without pigmentation; the protective sensation was restored in all cases, but there was no two-point discrimination; there was no obvious hypertrophic scarring or pain in the donor or recipient site. At the last follow-up, the curative effect of flap repair was evaluated with 3 flaps being excellent and 16 flaps being good; the extension and flexion functions of the reserved digital joint were also assessed, being excellent in 8 fingers, good in 9 fingers, and fair in 2 fingers.   Conclusions   The blood supply of superficial peroneal artery perforator flap is sufficient and reliable, and multiple flaps of this type or multiple flaps with one pedicle can be resected from one donor site. The use of this flap to repair small and medium-sized thermal crush injury wounds in the hand results in minimal damage to the donor area, and good postoperative appearance and texture of the flap.

     

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  • [1]
    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.
    [2]
    BigdeliAK,ThomasB,FalknerF,et al.Microsurgical reconstruction of extensive lower extremity defects with the conjoined parascapular and latissimus dorsi free flap[J].Microsurgery,2020,40(6):639-648.DOI: 10.1002/micr.30640.
    [3]
    JiaoX,CuiC,NgSK,et al.The modified bilobed flap for reconstructing sacral decubitus ulcers[J/OL].Burns Trauma,2020,8:tkaa012[2022-06-23].https://pubmed.ncbi.nlm.nih.gov/33335930/.DOI: 10.1093/burnst/tkaa012.
    [4]
    QingL,WuP,ZhouZ,et al.A design for the dual skin paddle circumflex scapular artery perforator flap for the reconstruction of complex soft-tissue defects in children: anatomical study and clinical applications[J].Ann Plast Surg,2019,83(4):439-446.DOI: 10.1097/SAP.0000000000001814.
    [5]
    中国老年医学学会烧创伤分会,中国生物材料学会烧创伤创面修复材料分会,中国医师协会创面修复专业委员会.热压伤创面临床诊疗全国专家共识(2023版)[J].中华烧伤与创面修复杂志,2023,39(3):201-208.DOI: 10.3760/cma.j.cn501225-20220608-00227.
    [6]
    LeeYJ,LeeYJ,OhDY,et al.Reconstruction of wide soft tissue defects with extended anterolateral thigh perforator flap turbocharged technique with anteromedial thigh perforator[J].Microsurgery,2020,40(4):440-446.DOI: 10.1002/micr.30549.
    [7]
    ZeidermanMR,PuLLQ.Contemporary approach to soft-tissue reconstruction of the lower extremity after trauma[J/OL].Burns Trauma,2021,9:tkab024[2022-06-23].https://pubmed.ncbi.nlm.nih.gov/34345630/.DOI: 10.1093/burnst/tkab024.
    [8]
    Fernández GarridoM,PereiraN,López FernándezS,et al.Turbocharged bilateral pedicled DIEP flap for reconstruction of thigh defect without recipient vessels: a case report[J].Microsurgery,2018,38(3):324-327.DOI: 10.1002/micr.30280.
    [9]
    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.
    [10]
    RodriguezIE,TrinhBB,DeleyiannisFW.Utility of an anterior tibial perforator for skin paddle viability in through-and-through defects of the mandible[J].Eplasty,2018,18:e24.
    [11]
    方杰,唐兆麟,吴尧,等.游离腓肠内侧动脉穿支皮瓣在四肢创面修复中的临床应用[J].中华解剖与临床杂志,2021,26(6):708-711.DOI: 10.3760/cma.j.cn101202-20210108-00010.
    [12]
    胡骁骅,覃凤均,李娟,等.穿支皮瓣整复严重烧伤患者四肢大关节部位瘢痕增生挛缩畸形的效果[J].中华烧伤杂志,2019,35(6):417-422.DOI: 10.3760/cma.j.issn.1009-2587.2019.06.004.
    [13]
    方鑫,胡沣,陈前永,等.前臂游离骨间后动脉分叶穿支皮瓣修复多指软组织缺损[J].创伤外科杂志,2022,24(6):420-423.DOI: 10.3969/j.issn.1009-4237.2022.06.005.
    [14]
    中华医学会烧伤外科学分会.磨痂术在烧伤创面中的临床应用全国专家共识(2021版)[J].中华烧伤杂志,2021,37(6):501-507.DOI: 10.3760/cma.j.cn501120-20210110-00013.
    [15]
    徐永清,何晓清,陈雪松,等.手和足部创面修复时四种吻合血管的皮神经营养血管穿支皮瓣的选择[J].中华显微外科杂志,2020,43(4):331-337.DOI: 10.3760/cma.j.cn441206-20200218-00068.
    [16]
    孙海峰,田明礼,王杨,等.应用足背动脉为蒂的双叶皮瓣修复多手指电烧伤创面[J].中国美容整形外科杂志,2018,29(10):618-619,后插7.DOI: 10.3969/j.issn.1673-7040.2018.10.012.
    [17]
    吴春,王正理,谭莉,等.股前外侧KISS皮瓣修复多个手指背侧软组织缺损[J].中华显微外科杂志,2020,43(1):37-41.DOI: 10.3760/cma.j.issn.1001-2036.2020.01.010.
    [18]
    李建杭,王洪刚,赵军,等.小型腓浅动脉穿支皮瓣在手指软组织缺损中的应用[J].实用手外科杂志,2019,33(4):383-385.DOI: 10.3969/j.issn.1671-2722.2019.04.005.
    [19]
    熊胜,巨积辉,金光哲,等.游离同侧多块小腿腓浅动脉穿支皮瓣修复手部多发创面效果观察[J].中华烧伤杂志,2019,35(9):655-660.DOI: 10.3760/cma.j.issn.1009-2587.2019.09.003.
    [20]
    熊胜,巨积辉,金光哲,等.彩超定位下游离腓浅动脉穿支皮瓣修复手足部创面[J].中华手外科杂志,2018,34(6):418-420.DOI: 10.3760/cma.j.issn.1005-054X.2018.06.007.
    [21]
    程贺云,张韬,巨积辉,等.Flow-through腓浅动脉皮瓣修复手指伴指掌侧固有动脉缺损创面[J].中华显微外科杂志,2021,44(4):369-373.DOI: 10.3760/cma.j.cn441206-20210111-00011.
    [22]
    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.
    [23]
    于涛,袁云华,张俊,等.带掌长肌腱的静脉皮瓣在指背皮肤伴伸肌腱缺损中的应用[J].中华显微外科杂志,2018,41(5):484-486.DOI: 10.3760/cma.j.issn.1001-2036.2018.05.017.
    [24]
    陈占斌,曹广超,杨龙,等.带阔筋膜游离股前外侧皮瓣修复伴肌腱缺损的创面[J].实用手外科杂志,2021,35(3):320-323.DOI: 10.3969/j.issn.1671-2722.2021.03.015.
    [25]
    赵海洋,韩军涛,刘佳琦,等.手持续被动运动系统联合功能训练与压力手套治疗手背部烧伤后早期瘢痕挛缩的效果[J].中华烧伤杂志,2021,37(4):319-326.DOI: 10.3760/cma.j.cn501120-20201020-00443.
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