Email Alerts
RSS
Volume 39 Issue 9
Sep.  2023
Turn off MathJax
Article Contents
Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(9): 835-841
Di HP,Xing PP,Zheng JJ,et al.Curative effects of ultrathin anterolateral femoral flap in one-stage split-finger repair of palmar combined with multiple finger wounds[J].Chin J Burns Wounds,2023,39(9):835-841.DOI: 10.3760/cma.j.cn501225-20221129-00514.
Citation: Di HP,Xing PP,Zheng JJ,et al.Curative effects of ultrathin anterolateral femoral flap in one-stage split-finger repair of palmar combined with multiple finger wounds[J].Chin J Burns Wounds,2023,39(9):835-841.DOI: 10.3760/cma.j.cn501225-20221129-00514.
shu

Curative effects of ultrathin anterolateral femoral flap in one-stage split-finger repair of palmar combined with multiple finger wounds

doi: 10.3760/cma.j.cn501225-20221129-00514
  • 1.

    Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China

  • 2.

    Institute of Biomedical Engineering and Health Sciences, Changzhou University, Changzhou 213164, China

Funds:

Henan Medical Science and Technology Research Program 232102311126

The Provincial and Ministerial Key Projects of Henan Medical Science and Technology Research Program SBGJ202102208

More Information
    Abstract
  •   Objective   To explore the curative effects of ultrathin anterolateral femoral flap in one-stage split-finger repair of palmar combined with multiple finger wounds.   Methods   A retrospective observational study was conducted. From October 2016 to June 2018, 20 patients with wounds on palms and multiple fingers who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, including 15 males and 5 females, aged 18 to 77 years. After debridement, the wound area was 8 cm×4 cm-17 cm×12 cm. The wound was repaired by ultrathin anterolateral femoral flap with area of 9 cm×5 cm to 19 cm×13 cm. According to the wound condition of finger, the finger division was performed in one stage, and the length-to-width ratio of the split-finger flap was 2.0:1.0-2.5:1.0. During the surgery, the descending branches of lateral circumflex femoral artery and accompanying vein of flap were anastomosed end-to-end to the radial artery and vein in the recipient area, respectively, and the anterolateral femoral cutaneous nerve of flap was bridged with the superficial branch of radial nerve in the recipient area. The wounds in the donor area of flap in 14 patients were sutured directly, the wounds in the donor area of flap in 3 patients were repaired by relay superficial iliac circumflex artery perforator flap, and the wounds in the donor area of flap in 3 patients were covered by free trunk medium-thick skin graft. The survival of flap, occurrence of vascular crisis and other complications, and healing of wounds in the donor area of flap were recorded. The appearance of flap, scar hyperplasia in the donor and recipient areas and the patients' satisfaction with the shape and function of the donor and recipient areas were followed up. In 1 year after surgery, the two-point discrimination distance of the flap was measured, and the recovery of hand function was evaluated by the trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association.   Results   The flaps of 17 patients survived without vascular crisis or other complications after surgery. The flap of 1 patient had poor blood circulation and partial necrosis, and the wound was healed 14 days after dressing change and grafting of split-thickness skin graft from head. Two patients had mild cyanosis at the margin of flap after surgery, which disappeared spontaneously 5 days later. Incisions at donor site, relay flaps, and skin grafts of all patients survived well. After surgery, the color and texture of flap were basically the same as that of the normal skin of hand, and linear scars were observed in the donor and recipient areas. The patients were satisfied with the recovery of appearance and function of donor and recipient areas. After 1 year of follow-up, the patients' hand sensory function recovered well, the two-point discrimination distance of flap was 4-6 mm, and the recovery of hand function was evaluated as excellent in 18 cases and good in 2 cases.   Conclusions   The ultrathin anterolateral femoral flap in repairing the palmar combined with multiple finger wounds in one-stage split-finger can significantly reduce the number of surgeries and improve the function and beauty of the hand, so it is worthy of clinical promotion.

     

    • FullText(HTML)
  • loading
    • References(29)
  • [1]
    张智.游离足背三叶皮瓣修复多指皮肤缺损5例分析[J].中国矫形外科杂志,2017,25(22):2100-2102.DOI: 10.3977/j.issn.1005-8478.2017.22.19.
    [2]
    WangF, PradhanP, LiN, et al. Tripaddled anterolateral thigh flap for the reconstruction of extensively full-thickness cheek defects by stacking two skin paddles as kiss pattern[J]. J Craniofac Surg, 2018, 29(3):651-654. DOI: 10.1097/SCS.0000000000004164.
    [3]
    李军,徐永清,戴莹.手部损伤的修复与重建[J].创伤外科杂志,2021,23(2):158-161.DOI: 10.3969/j.issn.1009-4237.2021.02.022.
    [4]
    潘生德, 顾玉东, 侍德,等. 中华医学会手外科学会上肢部分功能评定试用标准[J].中华手外科杂志,2000,16(3): 130-135. DOI: 10.3760/cma.j.issn.1005-054X.2000.03.003.
    [5]
    邹永通,刘晓军,练祝平,等.股前外侧穿支皮瓣移植在四肢严重创伤后皮肤缺损修复中的应用[J].海南医学,2017,28(11):1854-1856.DOI: 10.3969/j.issn.1003-6350.2017.11.046.
    [6]
    KimJH,YooH,EunS.Reconstruction of extensive soft tissue defects of lower extremity with the extended anterolateral thigh flap[J].Int J Low Extrem Wounds,2022,21(4):601-608.DOI: 10.1177/1534734620982238.
    [7]
    李友,巨积辉,徐磊,等.应用改良逆行岛状指背神经筋膜蒂皮瓣修复手指远端缺损[J].中国美容整形外科杂志,2020,31(7):415-417.DOI: 10.3969/j.issn.1673-7040.2020.07.010.
    [8]
    吴抽浪,章伏生,郑金满,等.下腹部双叶皮瓣修复手部深度烧伤八例[J]. 中华烧伤杂志,2008,24(4):297-298. DOI: 10.3760/cma.j.issn.1009-2587.2008.04.023.
    [9]
    黄书润,刘江涛,张勇,等.手部烧创伤后复杂创面的修复[J].中华烧伤杂志,2019,35(5):362-366.DOI: 10.3760/cma.j.issn.1009-2587.2019.05.007.
    [10]
    王辉,杨晓溪,刘冰冰,等.手部三种近位带蒂皮瓣接力修复手指指端脱套伤及供区软组织缺损的效果[J]. 中华烧伤与创面修复杂志,2021,37(1):64-69.DOI: 10.3760/cma.j.cn501120-20200103-00001.
    [11]
    黎章灿,郑大伟,齐伟亚,等.上臂内侧双叶游离皮瓣修复手部两处皮肤软组织缺损的效果[J]. 中华烧伤杂志,2019,35(8):604-607.DOI: 10.3760/cma.j.issn.1009-2587.2019.08.009.
    [12]
    狄海萍,夏成德,邢培朋,等.腕部游离穿支皮瓣修复手指电烧伤创面的临床效果[J].中华烧伤杂志,2017,33(9):557-561.DOI: 10.3760/cma.j.issn.1009-2587.2017.09.007.
    [13]
    周健,魏在荣,黄广涛,等. 改良掌背动脉皮支筋膜蒂皮瓣修复手指近节与中节创面的临床效果[J]. 中华烧伤杂志,2020,36(8):734-737.DOI: 10.3760/cma.j.cn501120-20200212-00055.
    [14]
    刘育杰,丁小珩, 焦鸿生,等. 多种游离微型穿支皮瓣修复手指皮肤缺损的疗效分析[J]. 中国美容整形外科杂志, 2017, 28(2):78-82,128.DOI: 10.3969/j.issn.1673-7040.2017.02.004.
    [15]
    李锦,武海波,金光哲,等. 第2趾胫侧趾背动脉皮瓣与第2趾胫侧趾底固有动脉皮瓣修复手指皮肤软组织缺损疗效的对比研究[J]. 中华烧伤与创面修复杂志,2022,38(10):937-943.DOI: 10.3760/cma.j.cn501120-20210909-00310.
    [16]
    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.
    [17]
    狄海萍,李永林,邢培朋,等.皮瓣修复腕部高压电烧伤创面的手术时机选择[J].中华显微外科杂志,2019,42(2):166-169.DOI: 10.3760/cma.j.issn.1001-2036.2019.02.016.
    [18]
    赵风景,章文锋,张兴群,等.股前外侧分叶皮瓣或肌皮瓣修复四肢皮肤软组织缺损七例[J]. 中华烧伤杂志,2017,33(6):390-392.DOI: 10.3760/cma.j.issn.1009-2587.2017.06.021.
    [19]
    LakhianiC,LeeMR,Saint-CyrM.Vascular anatomy of the anterolateral thigh flap: a systematic review[J].Plast Reconstr Surg,2012,130(6):1254-1268.DOI: 10.1097/PRS.0b013e31826d1662.
    [20]
    陈胜华, 徐达传, 周小兵,等. 以旋股外侧动脉降支为蒂分叶股前外侧肌皮瓣设计的解剖学研究[J]. 中国临床解剖学杂志, 2010, 28(3):237-241.DOI: 10.13418/j.issn.1001-165x.2010.03.002.
    [21]
    JanikS,HirtlerL,TraxlerH,et al.The vascularized fascia lata free flap: an anatomical study and clinical considerations[J].Eur Arch Otorhinolaryngol,2020,277(6):1733-1739.DOI: 10.1007/s00405-020-05861-8.
    [22]
    ZhangPP,MengL,ShenJ,et al.Free radial forearm flap and anterolateral thigh flap for reconstruction of hemiglossectomy defects: a comparison of quality of life[J].J Craniomaxillofac Surg,2018,46(12):2157-2163.DOI: 10.1016/j.jcms.2018.10.006.
    [23]
    申强.比较不同部位皮瓣移植对于颜面部不同类型皮肤软组织缺损的治疗疗效[J].中外医疗,2018,37(25):32-34.DOI: 10.16662/j.cnki.1674-0742.2018.25.032.
    [24]
    张子阳,唐修俊,魏在荣,等.保留𧿹展肌的改良游离足底内侧皮瓣修复手掌部瘢痕挛缩畸形[J].中国修复重建外科杂志,2018,32(7):951-954.DOI: 10.7507/1002-1892.201801141.
    [25]
    MatsumineH, KameiW, FujiiK, et al. One-stage reconstruction by dual-innervated double muscle flap transplantation with the neural interconnection between the ipsilateral masseter and contralateral facial nerve for reanimating established facial paralysis: a report of 2 cases[J]. Microsurgery,2019,39(5):457-462. DOI: 10.1002/micr.30397.
    [26]
    庄加川,张振伟,李敏姣,等.胸背动脉穿支皮瓣修复手部皮肤缺损的临床应用[J].中华手外科杂志,2018,34(3):161-163.DOI: 10.3760/cma.j.issn.1005-054X.2018.03.001.
    [27]
    周鹏飞,刘宏君,张乃臣,等.缝合与不缝合指固有神经掌侧皮支的指动脉逆行岛状皮瓣修复指端软组织缺损的疗效比较[J].中华手外科杂志,2019,35(3):232-234.DOI: 10.3760/cma.j.issn.1005-054X.2019.03.026.
    [28]
    许思亮,刘铭波,叶伟德,等.应用趾腹浅静脉回流型趾腹侧方皮瓣修复手指指腹软组织缺损[J].中华显微外科杂志,2018,41(1):86-88.DOI: 10.3760/cma.j.issn.1001-2036.2018.01.023.
    [29]
    韩春梅,彭剑飞,贾献磊,等.修薄的股前外侧穿支皮瓣修复多个手指软组织缺损[J].中华显微外科杂志,2019,42(4):391-393.DOI: 10.3760/cma.j.issn.1001-2036.2019.04.020.
    • 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(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (227) PDF downloads(23) 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