Clinical efficacy of layered thinning superficial circumflex iliac artery perforator flap based on color Doppler ultrasound positioning

Zhang Wentong; Yang Yong; Li Feng; Li Bin; Wang Dandan; Chen Tao; Li Jianfeng

doi:10.3760/cma.j.cn501225-20240927-00358

Volume 41 Issue 1

Jan. 2025

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2025 > 41(1): 45-52

Zhang WT,Yang Y,Li F,et al.Clinical efficacy of layered thinning superficial circumflex iliac artery perforator flap based on color Doppler ultrasound positioning[J].Chin J Burns Wounds,2025,41(1):45-52.DOI: 10.3760/cma.j.cn501225-20240927-00358.

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Clinical efficacy of layered thinning superficial circumflex iliac artery perforator flap based on color Doppler ultrasound positioning

doi: 10.3760/cma.j.cn501225-20240927-00358

1.
Department of Hand and Foot Surgery, Beijing Shunyi District Hospital, Beijing 101300, China
2.
Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China
3.
Department of Ultrasound Diagnosis, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China

Funds:

Beijing Health System High-Level Health Technical Personnel Training Plan 2015-3-036

Beijing Hospital Management Center "Peak" Talent Training Plan DFL20240402

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Corresponding author: Yang Yong, Email: 0414yang@sina.com
Received Date: 2024-09-27

Abstract

Abstract

Objective To explore the clinical efficacy of layered thinning superficial circumflex iliac artery perforator (SCIP) flap based on color Doppler ultrasound (CDU) positioning. Methods The study was a retrospective observational study. From February 2023 to February 2024, 14 patients who met the inclusion criteria were admitted to the Department of Hand Surgery of Beijing Jishuitan Hospital Affiliated to Capital Medical University, including 11 males and 3 females, aged 15 to 60 years. The wound area was from 7 cm×4 cm to 14 cm×11 cm. Before the flap transplantation surgery, CDU was used to accurately locate the deep fascial exit point of the superficial branch of the superficial circumflex iliac artery. During the surgery, the SCIP flap was thinned in layers to repair the hand and forearm wounds of 11 patients and foot wounds of 3 patients. The flap incision area ranged from 8 cm×5 cm to 15 cm×12 cm. The donor area wounds of flaps were sutured directly. During the surgery, the deep fascial exit point of the superficial branch of the superficial circumflex iliac artery in the flap donor area was observed and compared with the result of CDU positioning before the surgery, and the flap thickness was measured. The flap survival and occurrence of adverse reactions were observed after the surgery. During follow-up, the appearance and texture of flaps, and the wound healing in the donor area was observed. At the last follow-up, the function of the wrist and hand in the affected limbs was evaluated according to the trial standards for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association, and the function of the foot and ankle in the affected limbs was evaluated according to the scoring standard of American Orthopaedic Foot and Ankle Society. Results During the surgery, the deep fascial exit point of the superficial branch of the superficial circumflex iliac artery in the flap donor area was consistent with the result of CDU positioning before the surgery, and the distance between them was less than 10 mm. The flap thickness was 5 to 8 mm with an average of 6.2 mm. All the flaps survived after surgery. During the follow-up of 5 to 12 months, the flaps had good appearance and texture, all the wounds in the donor areas healed with only linear scar left. At the last follow-up, the function of the wrist and hand in the affected limbs was evaluated as excellent in 9 cases, good in one case, and fair in one case; the function of the foot and ankle in the affected limbs was evaluated as excellent in one case and good in two cases. Conclusions CDU examination can provide precise preoperative perforator positioning for layered thinning of SCIP flap and contribute to the optimization of flap design, so as to avoid the problem of flap necrosis caused by improper preoperative design to some extent and improve the safety of surgery. In addition, the layered thinning SCIP flap results in less damage to the donor area and is beneficial for the recovery of the affected limb function, which is worthy of clinical promotion.
- Surgical flaps,
- Perforator flap,
- Microsurgery,
- Ultrasonography, Doppler, color,
- Superficial circumflex iliac artery,
- Wound repair

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References(41)

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