CLINICAL STUDY ON ABDOMINAL EXPANDED SUBDERMAL VASCULAR PLEXUS SKIN FLAPS FORREPAIRING DORSAL HAND SCAR_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Shengyu , XIE Jianhua , LI Zaigui , LIU Haihua , ZHANG Kelu , ZHANG Yongqiang.

Department of Hand Surgery, Hengli People’s Hospital, Dongguan Guangdong, 523460, P.R.China.;

Corresponding author：

Keywords：

Subdermal vascular plexus flap, Abdominal expanded skin flap, Scar repair, Dorsal hand

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Objective To explore the method and effectiveness of abdominal expanded subdermal vascular plexus skin flaps in repairing dorsal hand scar. Methods Between May 2005 and October 2010, 16 cases of dorsal hand scars were
treated with the abdominal expanded flaps. There were 13 males and 3 females, aged 22.5 years on average (range, 10-35 years). Defect was caused by burn in 10 cases, hot crush injury in 4 cases, and scald injury in 2 cases. The average scar formation was 21 months (range, 1 year and 6 months to 2 years). The patients had flexion restriction of metacarpophalangeal joint and interphalangeal joint. The scar size ranged from 11 cm × 7 cm to 18 cm × 10 cm. The expander was implanted in abdominal skin and inflated with water regularly at the first stage. After 2 weeks, the expanded pedicled flap was trasferred to repair wounds in which scars were excised. The flap size ranged from 12 cm × 9 cm to 19 cm × 12 cm. After being cut off the pedicle at 14 days, the fingers were divided, and the digital web was formed. The abdominal donor site was directly sutured. Results All flaps survived. The wound and donor site achieved primary heal ing. Sixteen cases were followed up 1 year and 2 months to 3 years with an average of 2 years and 3 months. The flaps had soft texture and good flexibil ity. At last follow-up, hand function was graded as excellent in 13 cases, good in 2 cases, and poor in 1 case with an excellent and good rate of 93.7% according to the total active motion evaluation system. Conclusion Abdominal expanded subdermal vascular plexus skin flap is an effective method to repair large scar of the dorsal hand because it has satisfactory texture, fast rebuilding of blood supply, and large area of survival.

Citation： WANG Shengyu,XIE Jianhua,LI Zaigui,LIU Haihua,ZHANG Kelu,ZHANG Yongqiang.. CLINICAL STUDY ON ABDOMINAL EXPANDED SUBDERMAL VASCULAR PLEXUS SKIN FLAPS FORREPAIRING DORSAL HAND SCAR. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(5): 554-557. doi: Copy

1.	陶凯忠, 陈尔瑜, 党瑞山, 等. 肢体真皮下血管网. 解剖学杂志, 2003, 26(2): 169-171.
2.	马福顺, 杨智义, 原林, 等. 真皮下血管网皮瓣血循环途径的实验研究. 中华整形烧伤外科杂志, 1993, 9(5): 344-346.
3.	杨智义, 陈冰兵, 黄明跃, 等. 肩胸区超薄皮瓣在面颈部修复中的应用. 修复重建外科杂志, 1991, 5(3): 141-142.
4.	黄晓元, 梁鹏飞, 杨兴华, 等. 上臂真皮下血管网皮瓣与面颌部瘢痕瓣置换移植术. 中华烧伤杂志, 2005, 21(2): 117-118.
5.	罗立群, 徐启文, 徐柢邰, 等. 带蒂真皮下血管网皮瓣修复手前臂皮肤软组织缺损. 中国修复重建外科杂志, 2004, 18(5): 405.
6.	马显杰, 鲁开化, 艾玉峰, 等. 下腹部多个真皮下血管网皮瓣在手外伤修复中的应用. 中国美容医学, 2003, 12(1): 61-62.
7.	王俊生, 雷万军, 董长青, 等. 下腹部轴型动脉蒂的真皮下血管网皮瓣修复手部软组织缺损. 中华整形外科杂志, 2003, 19(4): 264.
8.	郭旭, 董华祥, 石涛, 等. 真皮下血管网皮瓣修复手指脱套伤38例. 中国修复重建外科杂志, 2007, 21(1): 94-95.
9.	林闻海, 郑廷忠, 王庆生, 等. 真皮下血管网皮瓣在手外伤修复中的应用. 中国修复重建外科杂志, 2005, 19(7): 528-530.
10.	李勤, 柳大烈, 刘晓燕, 等. 预扩张的颈浅动脉皮瓣移位修复颈部瘢痕挛缩. 中国修复重建外科杂志, 1999, 13(4): 235-236.
11.	Lu F, Gao JH, Ogawa R, et al. Preexpanded distant super-thin intercostal perforator flaps for facial reconstruction withoutthe need for microsurgery. J Plast Reconstr Aesthet Surg, 2006, 59(11): 1203-1208.
12.	Gao JH, Ogawa R, Hyakusoku H, et al. Reconstruction of the face and neck scar contractures using staged transfer of expanded super-thin flaps. Burns, 2007, 33(6): 760-763.
13.	李江, 王标, 陈铭锐, 等. 微创法超薄皮瓣式皮肤扩张法在面颈部瘢痕治疗中的应用. 中国美容医学, 2004, 13(2): 174-175.
14.	张继, 王春梅, 尹琳, 等. 扩张的超薄皮瓣分区修复颜面部烧伤瘢痕. 中国美容医学, 2007, 16(1): 47-51.
15.	张博, 王振国, 魏梦奇, 等. 含脐旁皮动脉真皮下血管网皮瓣的临床应用. 中国美容医学, 2004, 13(2): 218.
16.	Oqawa R, Hyakusoku H, Murakami M. Color Doppler ultrasonography in the planning of microvascular augmented super-thin flaps. Plast Reconstr Surg, 2003, 112(3): 822-828.
17.	黄以添, 魏明. 真皮下血管网皮瓣术后部分坏死5例报告. 广西医学, 2004, 26(1): 96-97.
18.	梁智, 任林森, 俞宝, 等. 真皮下血管网超薄皮瓣血运重建的实验研究 (三)——超薄皮瓣的再血管化与血供变化. 中国修复重建外科杂志, 1994, 8(4): 242-244.

1. 陶凯忠, 陈尔瑜, 党瑞山, 等. 肢体真皮下血管网. 解剖学杂志, 2003, 26(2): 169-171.
2. 马福顺, 杨智义, 原林, 等. 真皮下血管网皮瓣血循环途径的实验研究. 中华整形烧伤外科杂志, 1993, 9(5): 344-346.
3. 杨智义, 陈冰兵, 黄明跃, 等. 肩胸区超薄皮瓣在面颈部修复中的应用. 修复重建外科杂志, 1991, 5(3): 141-142.
4. 黄晓元, 梁鹏飞, 杨兴华, 等. 上臂真皮下血管网皮瓣与面颌部瘢痕瓣置换移植术. 中华烧伤杂志, 2005, 21(2): 117-118.
5. 罗立群, 徐启文, 徐柢邰, 等. 带蒂真皮下血管网皮瓣修复手前臂皮肤软组织缺损. 中国修复重建外科杂志, 2004, 18(5): 405.
6. 马显杰, 鲁开化, 艾玉峰, 等. 下腹部多个真皮下血管网皮瓣在手外伤修复中的应用. 中国美容医学, 2003, 12(1): 61-62.
7. 王俊生, 雷万军, 董长青, 等. 下腹部轴型动脉蒂的真皮下血管网皮瓣修复手部软组织缺损. 中华整形外科杂志, 2003, 19(4): 264.
8. 郭旭, 董华祥, 石涛, 等. 真皮下血管网皮瓣修复手指脱套伤38例. 中国修复重建外科杂志, 2007, 21(1): 94-95.
9. 林闻海, 郑廷忠, 王庆生, 等. 真皮下血管网皮瓣在手外伤修复中的应用. 中国修复重建外科杂志, 2005, 19(7): 528-530.
10. 李勤, 柳大烈, 刘晓燕, 等. 预扩张的颈浅动脉皮瓣移位修复颈部瘢痕挛缩. 中国修复重建外科杂志, 1999, 13(4): 235-236.
11. Lu F, Gao JH, Ogawa R, et al. Preexpanded distant super-thin intercostal perforator flaps for facial reconstruction withoutthe need for microsurgery. J Plast Reconstr Aesthet Surg, 2006, 59(11): 1203-1208.
12. Gao JH, Ogawa R, Hyakusoku H, et al. Reconstruction of the face and neck scar contractures using staged transfer of expanded super-thin flaps. Burns, 2007, 33(6): 760-763.
13. 李江, 王标, 陈铭锐, 等. 微创法超薄皮瓣式皮肤扩张法在面颈部瘢痕治疗中的应用. 中国美容医学, 2004, 13(2): 174-175.
14. 张继, 王春梅, 尹琳, 等. 扩张的超薄皮瓣分区修复颜面部烧伤瘢痕. 中国美容医学, 2007, 16(1): 47-51.
15. 张博, 王振国, 魏梦奇, 等. 含脐旁皮动脉真皮下血管网皮瓣的临床应用. 中国美容医学, 2004, 13(2): 218.
16. Oqawa R, Hyakusoku H, Murakami M. Color Doppler ultrasonography in the planning of microvascular augmented super-thin flaps. Plast Reconstr Surg, 2003, 112(3): 822-828.
17. 黄以添, 魏明. 真皮下血管网皮瓣术后部分坏死5例报告. 广西医学, 2004, 26(1): 96-97.
18. 梁智, 任林森, 俞宝, 等. 真皮下血管网超薄皮瓣血运重建的实验研究 (三)——超薄皮瓣的再血管化与血供变化. 中国修复重建外科杂志, 1994, 8(4): 242-244.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL STUDY ON ABDOMINAL EXPANDED SUBDERMAL VASCULAR PLEXUS SKIN FLAPS FORREPAIRING DORSAL HAND SCAR

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