Efficacy of free multiple lateral crural perforator flaps on one side under CDU precise localization for repairing multiple wounds at different sites on the finger

Cheng Heyun; Ju Jihui; Zhao Qiang; Hou Ruixing; Cheng Junnan; Liu Shuang; Wang Benyuan; Guo Quanwei; Zhou Wei

doi:10.3760/cma.j.cn501225-20241210-00484

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > > Accepted Manuscript

Cheng Heyun,Ju Jihui,Zhao Qiang,et al.Efficacy of free multiple lateral crural perforator flaps on one side under CDU precise localization for repairing multiple wounds at different sites on the finger[J].Chin J Burns Wounds,2026,42(2):1-7.DOI: 10.3760/cma.j.cn501225-20241210-00484.

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Efficacy of free multiple lateral crural perforator flaps on one side under CDU precise localization for repairing multiple wounds at different sites on the finger

doi: 10.3760/cma.j.cn501225-20241210-00484

Department of Hand Surgery, Suzhou Ruihua Orthopedic Hospital, Suzhou 215104, China

Funds:

Suzhou Key Medical Discipline SZXK202127

Suzhou Key Technology Research Program SYWD2025069

Wuzhong District Science and Technology Program WZYW2024008

More Information

Corresponding author: Zhao Qiang, Email: zq1025422@163.com
Received Date: 2024-12-10
Available Online: 2026-01-30

Abstract

Abstract

Objective To explore the efficacy of free multiple lateral crural perforator flaps on one side under color Doppler ultrasound (CDU) precise localization for repairing multiple wounds at different sites on the finger. Methods This study was a retrospective study of case series. From April 2018 to October 2022, 20 patients with 3 or 4 wounds at different sites on the finger who met the inclusion criteria were admitted to Suzhou Ruihua Orthopedic Hospital. There were 15 males and 5 females, aged 26 to 59 years. Preoperative CDU-guided precise perforator localization was performed. After intraoperative debridement, the single wound area ranged from 1.8 cm×1.2 cm to 8.0 cm×4.0 cm. Free multiple lateral crural perforator flaps on one side were harvested to repair the wounds, with the area of single flap resected ranging from 2.0 cm×1.3 cm to 9.0 cm×4.2 cm. The donor site wounds were closed by direct suturing. During surgery, the distance between perforator entry point and CDU-marked perforator location, perforator artery diameter, pedicle length, tunica intima condition, and perforator origin were recorded. After surgery, the occurrence of vascular crisis and flap survival were recorded. The wound recovery in recipient and donor areas were recorded during follow-up. At the final follow-up, the sensory function of the flaps was assessed by the sensory function evaluation standard of the British Medical Research Council, and the flap repair outcome was evaluated using a flap comprehensive assessment scale. Results During surgery, the distances between perforator entry point and CDU-marked perforator location ranged from 0 to 5 mm, the perforator artery diameters ranged from 0.3 to 0.7 mm, the pedicle lengths ranged from 3 to 8 cm, and the tunica intima was smooth, flat, and elastic. Fifty-one perforators were originated from the superficial peroneal artery, 8 perforators were originated from the anterior tibial artery, and 6 perforators were originated from the peroneal artery. After surgery, two flaps developed arterial crisis, which both survived after surgical exploration and arterial reanastomosis. The other flaps survived. During follow-up of 4-14 months, the flaps exhibited good texture, no significant swelling, and no noticeable color difference from the recipient site; neither donor nor recipient sites showed pain or significant scar hyperplasia. At the final follow-up, the sensory function rating of the flaps was graded as S2 in 31 flaps and S3 in 34 flaps, the flap repair outcome was evaluated as excellent in 21 flaps and good in 44 flaps. Conclusions The lateral cutaneous perforators of the lower leg offer several advantages, including numerous vessels, large caliber, long pedicle, high-quality endangium, and multiple source arteries. The application of free multiple lateral crural perforator flaps on one side under CDU precise localization for repairing multiple wounds at different sites on the finger has low surgical risk, excellent flap repair outcome, and minimal number and damage of donor site.
- Surgical flaps,
- Perforator flap,
- Hand,
- Microsurgery,
- Ultrasound, Doppler, color,
- Perforator vessel localization

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References(38)

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