YANGHuanyou 1 , ZHANGJian 1 , ZHOUHongguang 2 , HUOYongxin 1 , LIUWei 1 , ZHANGJianfeng 1
  • 1. The 1st Department of Hand Surgery, Department of Reparative and Reconstructive Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China;
  • 2. Department of Orthopedics, Caofeidian District Hospital of Tangshan;
YANGHuanyou, Email: yanghuanyou123@126.com
Dissociative saphenous arteria flap; Saphenous artery; Upper limb; Wound repair
10.7507/1002-1892.20150127
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Objective To explore the effectiveness of the dissociative saphenous arteria flap in repairing upper limbs soft tissue defect. Methods Between June 2012 and April 2014, 10 cases of skin and soft tissue defects at the upper limbs were treated, including 6 males and 4 females with an average age of 42 years (range, 23-58 years). The causes of injury was the machine injury in 9 cases, the interval of injury and operation was 2 hours to 32 days (mean, 5.5 days); the locations were the dorsal radial side in 3 cases and the dorsal forearm in 6 cases. Skin defect with tendon exposure was observed in 1 case after contracture of the first web space resection. The defect size varied from 5 cm×3 cm to 16 cm×9 cm. The size of the flaps ranged from 6.0 cm×3.6 cm to 19.2 cm×10.8 cm. In 7 cases, the saphenous nerve was anastomosed with the nerve of the donor (cutaneous nerve, radial nerve, or ulnar nerve); in 5 cases, tendon defect was repaired by sartorius muscle tendon bridge. The donor sites were repaired by free skin graft or suture. Results The other flaps survived and obtained healing by first intention except 1 flap which had partial necrosis with healing by second intention. The skin graft at donor site survived. All patients were followed up 5-17 months (mean, 12 months). The flaps had good color and texture without contracture. At last follow-up, the sensation recovered to S1-S3+; in 7 cases undergoing nerve anastomosis, the sensation reached S3-S3+, and it was better than that not undergoing nerve anastomosis (S1-S2); in 5 cases receiving sartorius muscle tendon bridging, the hand function recovered satisfactorily except 1 case of total active movement (TAM) value >75% of contralateral TAM at last follow-up. According to the Chinese Medical Society of Hand Surgery function evaluation standards, the results were excellent in 8 cases and good in 2 cases. Conclusion The dissociative saphenous arteria flap is an effective way to repair skin defects of the upper limbs because of reliable blood supply and simple surgical procedure.

Citation： YANGHuanyou, ZHANGJian, ZHOUHongguang, HUOYongxin, LIUWei, ZHANGJianfeng. REPAIR OF UPPER LIMBS TISSUE DEFECT WITH DISSOCIATIVE SAPHENOUS ARTERIA FLAP. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(5): 586-589. doi: 10.7507/1002-1892.20150127 Copy

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