CLINICAL APPLICATION OF LATERAL ARM LOBULATED FLAPS TO REPAIR MULTIPLE SOFT TISSUE DEFECT OF HAND_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YEShuming ¹ , TENGXiaofeng ² , CHENHong ² ,  JINGJuehua ¹ , ZHANGJisen ¹

1. Department of Orthopaedics, the Second Affiliated Hospital of Anhui Medical University, Hefei Anhui, 236001, P. R. China;
2. Department of Hand Surgery, Ningbo No.6 Hospital;

Corresponding author：

JINGJuehua, Email: jjhhu@sina.com

Keywords：

Lateral arm lobulated flap; Multiple soft tissue defects; Flap repair; Hand

DOI：

10.7507/1002-1892.20160089

Video：

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Objective To explore the effectiveness and operation of repairing multiple soft tissue defects in hands with lateral arm lobulated flaps. Method Between October 2013 and September 2015, 13 cases of multiple soft tissue defects in the hand with tendon or bone exposure were treated with lateral arm lobulated flaps. All patients were males with average age of 28 years (range, 23-45 years). Defects were caused by penetrating injury in 7 cases, traffic accident injury in 3 cases, and hot-crush injury in 3 cases. Six patients had skin defect of the left 2 fingers after opening finger amputation, and 7 patients had skin defect of the palm and the back after hand injury. The size of skin defects ranged from 6 cm×5 cm to 9 cm×6 cm. All patients underwent emergency debridement and two-stage repair; the duration from injury to operation was 5-9 days (mean, 7 days). The size of flap was 6 cm×5 cm-9 cm×6 cm. Results All flaps survived completely, with no vascular crisis. Primary healing was obtained at donor and recipient sites, and the grafted skin survived. All cases were followed up 3-24 months (mean, 12 months). The appearance and texture of the flaps were similar to those of adjacent skin. Bulky flap was observed in 4 cases, and second stage operation was performed to make the flap thinner at 3 months after operation. The sensation of flap reached S₃-S₄. Conclusions The lateral arm lobulated flap based on the radial collateral artery has constant vascular anatomy, easy-to-harvest, and large rotation angle. It is an effective procedure to repair small and medium size skin defects of the hand with satisfied texture and sensory recovery.

Citation： YEShuming, TENGXiaofeng, CHENHong, JINGJuehua, ZHANGJisen. CLINICAL APPLICATION OF LATERAL ARM LOBULATED FLAPS TO REPAIR MULTIPLE SOFT TISSUE DEFECT OF HAND. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(4): 444-446. doi: 10.7507/1002-1892.20160089 Copy

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2.	金秀, 王涛, 蒋子平, 等. 四肢电烧伤创面的皮瓣修复. 中华显微外科杂志, 2015, 38(2) :120-122.
3.	张丕红, 张明华, 谢庭鸿, 等. 游离上臂外侧穿支皮瓣修复手足部电烧伤创面. 中华烧伤杂志, 2015, 29(5) :424-426.
4.	梅良斌, 朱跃良, 王毅, 等. 游离上臂外侧皮瓣修复手足皮肤缺损. 中华创伤骨科杂志, 2014, 16(4) :357-358.
5.	杨卫玺, 李春江, 王一兵, 等. 游离上臂外侧皮瓣修复手部深度烧伤. 中华显微外科杂志, 2010, 33(5) :436.
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8.	王彦生, 张辉, 沈勇, 等. 游离组织移植修复前臂软组织缺损的临床研究. 中华手外科杂志, 2014, 30(3) :203-205.
9.	孙广峰, 魏在荣, 金文虎, 等. 扩张髂腹股沟超薄皮瓣修复手部前臂瘢痕. 中华手外科杂志, 2015, 31(1) :53-55.
10.	周福临, 陈伟, 张毅, 等. 改良骨间背骨皮瓣修复手背皮肤合并掌骨缺损的临床应用. 中华手外科杂志, 2014, 30(4) :305-306.
11.	周炎, 陈振兵, 瞿新丛, 等. 应用带血管蒂皮瓣修复手背软组织缺损. 中华手外科杂志, 2014, 30(4) :303-304.
12.	孟祥海, 王晓琳, 李学拥, 等. 复合皮移植修复烧伤功能部位创面疗效评价. 中国修复重建外科杂志, 2012, 26(2) :219-222.
13.	庄加川, 李敏姣, 陈乐锋, 等. 上臂内侧游离皮瓣修复手部皮肤缺损的临床应用. 中华手外科杂志, 2015, 31(3) :185-187.
14.	戚建武, 柴益铜, 王科杰, 等. 游离腹股沟皮瓣修复手部皮肤缺损. 中华手外科杂志, 2013, 29(5) :271-273.
15.	周晓, 芮永军, 寿奎水, 等. 近节掌指背皮瓣修复指根部岛状皮瓣供区的临床应用. 中华手外科杂志, 2012, 28(4) :221-223.
16.	Song R, Song Y, Yu Y, et al. The upper arm free flap. Clin Plast Surg, 1982, 9(1) :27-35.
17.	Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap:anatomy and clinical applications. Ann Plast Surg, 1984, 12(2) :489-500.
18.	孙瑞梅, 王金德, 李群, 等. 改良游离上臂外侧皮瓣应用解剖研究. 中华耳鼻咽喉头颈外科杂志, 2013, 48(1) :37-41.

1. 赵志钢, 王剑利, 魏海温, 等. 毁损性手外伤急诊修复与重建的方法选择. 中华显微外科杂志, 2013, 36(4) :395-397.
2. 金秀, 王涛, 蒋子平, 等. 四肢电烧伤创面的皮瓣修复. 中华显微外科杂志, 2015, 38(2) :120-122.
3. 张丕红, 张明华, 谢庭鸿, 等. 游离上臂外侧穿支皮瓣修复手足部电烧伤创面. 中华烧伤杂志, 2015, 29(5) :424-426.
4. 梅良斌, 朱跃良, 王毅, 等. 游离上臂外侧皮瓣修复手足皮肤缺损. 中华创伤骨科杂志, 2014, 16(4) :357-358.
5. 杨卫玺, 李春江, 王一兵, 等. 游离上臂外侧皮瓣修复手部深度烧伤. 中华显微外科杂志, 2010, 33(5) :436.
6. 高树林, 曹艳, 唐永丰, 等. 臂外侧下部游离皮瓣在手部创面修复中的应用. 中华显微外科杂志, 2010, 33(2) :155-156.
7. 李赞, 喻建军, 黄文孝, 等. 游离上臂外侧皮瓣在头颈肿瘤术后缺损修复的临床应用. 组织工程与外科重建杂志, 2007, 3(2) :83-85.
8. 王彦生, 张辉, 沈勇, 等. 游离组织移植修复前臂软组织缺损的临床研究. 中华手外科杂志, 2014, 30(3) :203-205.
9. 孙广峰, 魏在荣, 金文虎, 等. 扩张髂腹股沟超薄皮瓣修复手部前臂瘢痕. 中华手外科杂志, 2015, 31(1) :53-55.
10. 周福临, 陈伟, 张毅, 等. 改良骨间背骨皮瓣修复手背皮肤合并掌骨缺损的临床应用. 中华手外科杂志, 2014, 30(4) :305-306.
11. 周炎, 陈振兵, 瞿新丛, 等. 应用带血管蒂皮瓣修复手背软组织缺损. 中华手外科杂志, 2014, 30(4) :303-304.
12. 孟祥海, 王晓琳, 李学拥, 等. 复合皮移植修复烧伤功能部位创面疗效评价. 中国修复重建外科杂志, 2012, 26(2) :219-222.
13. 庄加川, 李敏姣, 陈乐锋, 等. 上臂内侧游离皮瓣修复手部皮肤缺损的临床应用. 中华手外科杂志, 2015, 31(3) :185-187.
14. 戚建武, 柴益铜, 王科杰, 等. 游离腹股沟皮瓣修复手部皮肤缺损. 中华手外科杂志, 2013, 29(5) :271-273.
15. 周晓, 芮永军, 寿奎水, 等. 近节掌指背皮瓣修复指根部岛状皮瓣供区的临床应用. 中华手外科杂志, 2012, 28(4) :221-223.
16. Song R, Song Y, Yu Y, et al. The upper arm free flap. Clin Plast Surg, 1982, 9(1) :27-35.
17. Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap:anatomy and clinical applications. Ann Plast Surg, 1984, 12(2) :489-500.
18. 孙瑞梅, 王金德, 李群, 等. 改良游离上臂外侧皮瓣应用解剖研究. 中华耳鼻咽喉头颈外科杂志, 2013, 48(1) :37-41.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF LATERAL ARM LOBULATED FLAPS TO REPAIR MULTIPLE SOFT TISSUE DEFECT OF HAND

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