Upper limb free mini-flap transplantation for repair of finger wounds

doi:10.3969/j.issn.2095-4344.2014.29.027

Abstract

Abstract:

BACKGROUND: Recently, the clinical repair methods of irregular wound on fingers primarily include local pedicled flap and free mini-flap of upper extremities or lower extremities.

OBJECTIVE: To discuss the application of free mini-flap derived from upper limb in repairing the wound on fingers.

METHODS: From December 2010 to February 2014, 12 patients with irregular wounds on 12 fingers were selected from Department of Traumatic Orthopaedics and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, China. The size of wounds ranged from 1.5 cm × 2.0 cm to 3.0 cm × 4.5 cm with different degrees of bone or tendon exposure. After the debridement, 12 patients were treated by free mini-flaps of upper limb. The donor sites were directly sutured.

RESULTS AND CONCLUSION: Among the 12 patients, all the wounds at recipient and donor sites were healed at stage I, and the free mini-flags survival completely. All of patients were followed up for 3-6 months (average

4.5 months). Free mini-flags had good appearance and needn’t undergo secondary trimming. The active motion of fingers was improved dominantly. According to the criteria of Hand Surgery Association Society of Chinese Medical Association Society for the function evaluation of upper limb, three cases were excellent, eight were good, and only one was bad. The excellent and good rate was 91%. Free mini-flaps of upper limb are an ideal method for repair of wounds on fingers. It has no injury to normal tissue in hands, donor site is very secluded, and the short-term curative effect is good.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

全文链接：

Key words: micromanipulation, surgical flaps, fingers, reconstructive surgical procedures

CLC Number:

R318

Cheng Jian-wen, Zhao Jin-min, Tan Zhen, Wang Jing-wei, Xue Ming-qiang. Upper limb free mini-flap transplantation for repair of finger wounds [J]. Chinese Journal of Tissue Engineering Research, 2014, 18(29): 4752-4756.

Figures/Tables 1

References

[1] Angermann P, Lohmann M. Injuries to the hand and wrist: a study of 50,272 injuries. J Hand Surg Br. 1993;18(5):642-644.

[2] O’sullivian ME, Colville J. The economic impact of hand injuries. J Hand Surg Br. 1993;18(3):395-398.

[3] 彭峰,赵根明,谷玉东.医院急诊手外伤病例的描述性流行病学调查报告[J].中华手外科杂志,2000,16(2):86-89.

[4] 范启申,周祥吉,高学建.手部严重组织缺损急诊显微外科修复与Ⅰ期功能重建[J].中国矫形外科杂志,2008,16(2):111-114.

[5] 徐跃根,卢厚微,吴可沁,等.急诊应用五种带血管蒂微型岛状皮瓣修复手指皮肤缺损[J].中华手外科杂志,2004,20(4):252.

[6] 侯书健,程国良,方光荣,等.足部皮瓣移植修复拇、手指皮肤缺损[J].中华手外科杂志,2005,21:334-336.

[7] State Council of the People's Republic of China. Administrative Regulations on Medical Institution. 1994-09-01.

[8] 方光荣.微型皮瓣在手外科的应用[J].实用手外科杂志, 2000,14: 131-135.

[9] 薛明强.桡动脉穿支皮瓣游离移植修复手指末端组织缺损[J].中华显微外科杂志,2012,35(6):487-488.

[10] 钟世镇,徐达传,丁自海.显微外科临床解剖学[M].济南:山东科学技术出版社, 2000:79-80.

[11] 潘达德,顾玉东,侍德,等.中华医学会手外科学会上肢部分功能评定试用标准[J].中华手外科杂志,2000,16(3):130-135.

[12] 郭解军.外科皮瓣在手外外伤急诊修复中的临床应用[J].中华显微外科杂志,2006,29(2):144-146.

[13] 方光荣.微型皮瓣在手外科中的应用[J].中国实用手外科杂志, 2000,14(3):131-136.

[14] 顾玉东.显微外科在手外科领域的应用与发展[J].中华显微外科杂志,2007,30(4):243-244.

[15] 梅劲,宋铁山,戴开宇,等.人体皮动脉的解剖学定位定量研究[J].中国临床解剖学杂志,2006,24:236-239.

[16] 庞水发,常湘珍,张方晨,等.皮瓣移植临床应用应坚持原则[J].中华显微外科杂志,2010,33(1):1-2.

[17] 苏伟,赵劲民,韦献良.碗掌侧浅静脉的解剖学观察及临床意义[J].中国骨与关节损伤杂志,2006,21(7):521-523.

[18] 晏桂明,谢振荣,梁敏.游离微型静脉皮瓣在断指再植中的应用[J].中华显微外科杂志,2003,26(4):316.

[19] Tiengo C, Macchi V, Porzionato A, et al. The proximal radial artery perforator flap (PRAP-flap): an anatomical study for its use in elbow reconstruction. Surg Radial Anat. 2007;29: 245-251.

[20] 庄加川,李敏姣.尺动脉腕上穿支游离皮瓣的临床应用[J].海南医学,2012,23(6):52-54.

[21] 张敬良,谢振荣,雷艳文,等.骨间后动脉单一穿支微型皮瓣的游离移植[J].中华显微外科杂志,2006,29:183-185.

[22] 刘鸣江,黄新锋.臂外侧穿支皮瓣的应用解剖学研究[J].中南医学科学杂志,2011,39(5):522-523, 528.

[23] 张世民,徐达传.穿支皮瓣[J].中国临床解剖学杂志, 2004,22(1): 32-33, 35.