Repair of resurfacing soft tissue defect of hand with radial collateral artery polyfoliate perforator flap_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YU Fang ,  TANG Juyu , WU Panfeng , ZHOU Zhengbing , PANG Xiaoyang , ZENG Lei , XIAO Yongbing , PAN Ding , QING Liming , LIU Rui

Department of Hand and Microsurgery, Xiangya Hospital Central South University, Changsha Hunan, 410008, P.R.China;

Corresponding author：

TANG Juyu, Email: tangjuyu7749@163.com

Keywords：

Perforator flap; polyfoliate flap; radial collateral artery; hand; wound repair

DOI：

10.7507/1002-1892.201902005

Video：

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Objective To explore the feasibility and effectiveness of radial collateral artery polyfoliate perforator flap in repair of resurfacing soft tissue defect of hand. Methods Between September 2017 and September 2018, the radial collateral artery polyfoliate perforator flaps were transplanted to repair 5 cases of two adjacent wounds of hand and wide or irregular wounds. All patients were male, aged from 27 to 52 years, with an average of 42.5 years. The time from injury to admission was 4 hours to 3 weeks, with an average of 7.3 days. Causes of injury included traffic accident in 2 cases, crushing injury in 2 cases, and paint injection injury in 1 case. The wounds were located at the dorsum of hand in 3 cases, the dorsum of finger in 1 case, and the thumb and thumb web in 1 case. The area of wound ranged from 8 cm×6 cm to 10 cm×8 cm. The area of skin flap ranged from 6.0 cm×3.0 cm to 11.0 cm×4.5 cm, all of which carried the posterior cutaneous nerve of the arm, and the donor site was closed directly. Results All flaps survived and healed by first intention. All patients were followed up 3-11 months (mean, 6.5 months). The patients were satisfied with the appearance of hands. The flaps were not bulky, and the color and texture were similar to the hand. There was only linear scar in the donor site, no radial nerve injury occurred, and elbow joint function was not affected. One patient underwent finger-splitting and skin flap thinning at 6 months after operation. Conclusion The radial collateral artery polyfoliate perforator flap is a good method for repairing two adjacent wounds and wide or irregular wounds of hand.

Citation： YU Fang, TANG Juyu, WU Panfeng, ZHOU Zhengbing, PANG Xiaoyang, ZENG Lei, XIAO Yongbing, PAN Ding, QING Liming, LIU Rui. Repair of resurfacing soft tissue defect of hand with radial collateral artery polyfoliate perforator flap. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(6): 721-725. doi: 10.7507/1002-1892.201902005 Copy

1.	朱庆生, 李华林, 吴克俭, 等. 臂外侧皮瓣游离移植修复手部皮肤缺损. 中国修复重建外科杂志, 1995, 9(4): 261.
2.	芮永军, 李向荣, 张全荣, 等. 上臂外侧皮瓣的临床应用. 中国修复重建外科杂志, 1994, 8(1): 52.
3.	Haas F, Rappl T, Koch H, et al. Free osteocutaneous lateral arm flap: anatomy and clinical applications. Microsurgery, 2003, 23(2): 87-95.
4.	Chen HC, el-Gammal TA. The lateral arm fascial free flap for resurfacing of the hand and fingers. Plast Reconstr Surg, 1997, 99(2): 454-459.
5.	刘宏君, 张文忠, 王天亮, 等. 游离上臂外侧皮瓣修复手部热压伤 15 例. 中华整形外科杂志, 2016, 32(5): 337-339.
6.	Song R, Song Y, Yu Y, et al. The upper arm free flap. Clin Plast Surg, 1982, 9(1): 27-35.
7.	唐举玉, 李康华, 廖前德, 等. 穿支皮瓣移植修复四肢软组织缺损 108 例. 中华显微外科杂志, 2010, 33(3): 186-189.
8.	唐举玉. 特殊形式穿支皮瓣的临床应用教程. 中华显微外科杂志, 2013, 36(2): 201-205.
9.	Hwang K, Lee WJ, Jung CY, et al. Cutaneous perforators of the upper arm and clinical applications. J Reconstr Microsurg, 2005, 21(7): 463-469.
10.	Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg, 1984, 12(6): 489-500.
11.	Brandt KE, Khouri RK. The lateral arm/proximal forearm flap. Plast Reconstr Surg, 1993, 92(6): 1137-1143.
12.	Kuek LB, Chuan TL. The extended lateral arm flap: a new modification. J Reconstr Microsurg, 1991, 7(3): 167-173.
13.	陈勇, 杨旭东, 李威, 等. 游离延展上臂外侧皮瓣修复洞穿性颊部缺损一例. 中国修复重建外科杂志, 2012, 26(4): 508-510.
14.	叶曙明, 滕晓峰, 陈宏, 等. 游离上臂外侧分叶皮瓣修复手部多创面皮肤缺损的临床应用. 中国修复重建外科杂志, 2016, 30(4): 444-446.
15.	胡浩良, 李学渊, 周晓玲, 等. 个性化设计游离上臂外侧穿支皮瓣修复手部不规则皮肤软组织缺损. 中国修复重建外科杂志, 2015, 29(12): 1510-1514.
16.	Carr LW, Brooke SM, Johnson TS, et al. Reexploring the anatomy of the distal humerus for its role in providing vascularized bone. Plast Reconstr Surg Glob Open, 2018, 6(1): e1636.
17.	李学渊, 黄剑, 胡浩良, 等. 游离上臂外侧组合穿支皮瓣修复上肢较大面积皮肤软组织缺损. 中华手外科杂志, 2015, 31(6): 418-420.
18.	李国栋, 徐永清, 何晓清, 等. 数字化技术在外侧腓肠浅动脉穿支皮瓣修复手部中小创面中的应用研究. 中国修复重建外科杂志, 2017, 31(5): 564-569.
19.	唐举玉, 卿黎明, 贺继强, 等. 数字化技术辅助旋股外侧动脉降支分叶穿支皮瓣设计的初步应用. 中华显微外科杂志, 2016, 39(2): 123-126.

1. 朱庆生, 李华林, 吴克俭, 等. 臂外侧皮瓣游离移植修复手部皮肤缺损. 中国修复重建外科杂志, 1995, 9(4): 261.
2. 芮永军, 李向荣, 张全荣, 等. 上臂外侧皮瓣的临床应用. 中国修复重建外科杂志, 1994, 8(1): 52.
3. Haas F, Rappl T, Koch H, et al. Free osteocutaneous lateral arm flap: anatomy and clinical applications. Microsurgery, 2003, 23(2): 87-95.
4. Chen HC, el-Gammal TA. The lateral arm fascial free flap for resurfacing of the hand and fingers. Plast Reconstr Surg, 1997, 99(2): 454-459.
5. 刘宏君, 张文忠, 王天亮, 等. 游离上臂外侧皮瓣修复手部热压伤 15 例. 中华整形外科杂志, 2016, 32(5): 337-339.
6. Song R, Song Y, Yu Y, et al. The upper arm free flap. Clin Plast Surg, 1982, 9(1): 27-35.
7. 唐举玉, 李康华, 廖前德, 等. 穿支皮瓣移植修复四肢软组织缺损 108 例. 中华显微外科杂志, 2010, 33(3): 186-189.
8. 唐举玉. 特殊形式穿支皮瓣的临床应用教程. 中华显微外科杂志, 2013, 36(2): 201-205.
9. Hwang K, Lee WJ, Jung CY, et al. Cutaneous perforators of the upper arm and clinical applications. J Reconstr Microsurg, 2005, 21(7): 463-469.
10. Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg, 1984, 12(6): 489-500.
11. Brandt KE, Khouri RK. The lateral arm/proximal forearm flap. Plast Reconstr Surg, 1993, 92(6): 1137-1143.
12. Kuek LB, Chuan TL. The extended lateral arm flap: a new modification. J Reconstr Microsurg, 1991, 7(3): 167-173.
13. 陈勇, 杨旭东, 李威, 等. 游离延展上臂外侧皮瓣修复洞穿性颊部缺损一例. 中国修复重建外科杂志, 2012, 26(4): 508-510.
14. 叶曙明, 滕晓峰, 陈宏, 等. 游离上臂外侧分叶皮瓣修复手部多创面皮肤缺损的临床应用. 中国修复重建外科杂志, 2016, 30(4): 444-446.
15. 胡浩良, 李学渊, 周晓玲, 等. 个性化设计游离上臂外侧穿支皮瓣修复手部不规则皮肤软组织缺损. 中国修复重建外科杂志, 2015, 29(12): 1510-1514.
16. Carr LW, Brooke SM, Johnson TS, et al. Reexploring the anatomy of the distal humerus for its role in providing vascularized bone. Plast Reconstr Surg Glob Open, 2018, 6(1): e1636.
17. 李学渊, 黄剑, 胡浩良, 等. 游离上臂外侧组合穿支皮瓣修复上肢较大面积皮肤软组织缺损. 中华手外科杂志, 2015, 31(6): 418-420.
18. 李国栋, 徐永清, 何晓清, 等. 数字化技术在外侧腓肠浅动脉穿支皮瓣修复手部中小创面中的应用研究. 中国修复重建外科杂志, 2017, 31(5): 564-569.
19. 唐举玉, 卿黎明, 贺继强, 等. 数字化技术辅助旋股外侧动脉降支分叶穿支皮瓣设计的初步应用. 中华显微外科杂志, 2016, 39(2): 123-126.

Chinese Journal of Reparative and Reconstructive Surgery

Repair of resurfacing soft tissue defect of hand with radial collateral artery polyfoliate perforator flap

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