IMPROVED PEDICLED SUPERFICIAL ILIAC CIRCUMFLEX ARTERY FLAP FOR RECONSTRUCTION OF HAND AND FOREARM WOUNDS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TANG Xiujun , WEI Zairong , WANG Bo , ZENG Xueqin , TAN Jing.

Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563003, P.R.China. Corresponding author: TANG Xiujun, E-mail: xiujunsszx@163.com;

Corresponding author：

Keywords：

Pedicled superficial iliac circumflex artery; flap Improved pedicle; Hand and forearm wound; Wound repair

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Objective To explore the effectiveness of the improved pedicled superficial iliac circumflex artery flap for repairing serious wound of the hand and forearm. Methods Between June 2008 and June 2011, 13 cases of serious wound of the hand and forearm were treated. There were 9 males and 4 females with a mean age of 41 years (range, 23-64 years). The disease causes included twist injury by machine in 2 cases, wire rope squeezed injury in 4 cases, traffic accident injury in 3 cases, crushing injury in 2 cases, high voltage electrical injury in 1 case, and snake bites in 1 case. There were 10 cases of fresh wounds and 3 cases of infection and necrosis wounds, and all had bone and tendon exposure. The skin and soft tissue defects ranged from 7 cm × 3 cm to 22 cm × 6 cm. The pedicled iliac artery flap was used in 8 cases, and pedicled iliac artery composite flap in 5 cases. The flap size ranged from 12 cm × 4 cm to 27 cm × 8 cm, with the flap pedicle of 2-4 cm wide strip and 3-5 cm wide fascia. Results The pedicle of flap was cut at 3 weeks in 12 patients, and at 4 weeks in 1 patient who had partial avulsion and hemorrhage at 1 week after operation. All flaps survived and incisions at donors and wounds healed by first intention. Eleven patients were followed up 6-36 months (mean, 20 months). The flap color and texture were good; 3 bulky flaps were observed, and satisfactory appearance was achieved after skin flap thinning. After 6 months, the protective sensation recovered in all cases; according to the Hand Surgery Society of Chinese Medical Association evaluation of upper extremity function trial standard for total active motion of the fingers, the results were excellent in 9 cases, good in 1 case, and poor in 1 case. Conclusion Improved fascia pedicled superficial iliac circumflex artery skin flap can repair serious hand and forearm injury, which is easy-to-operate and less injury at donor site.

Citation： TANG Xiujun,WEI Zairong,WANG Bo,ZENG Xueqin,TAN Jing.. IMPROVED PEDICLED SUPERFICIAL ILIAC CIRCUMFLEX ARTERY FLAP FOR RECONSTRUCTION OF HAND AND FOREARM WOUNDS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(8): 943-945. doi: Copy

1.	阳运康, 鲁晓波, 张忠杰, 等. 带蒂尺动脉腕上皮支皮瓣修复对侧手指脱套伤. 中国修复重建外科杂志, 2011, 25(2): 202-205.
2.	林涧, 郑和平. 前臂后外侧中段穿支皮瓣的临床应用. 中华显微外科杂志, 2010, 33(6): 490-491.
3.	齐杰, 李雯, 刘艳杰, 等. 前臂外侧皮神经营养血管逆行蒂岛状皮瓣修复手背软组织缺损. 中华整形外科杂志, 2010, 26(4): 241-243.
4.	Unal C, Ozdemir J, Hasdemir M. Clinical application of distal ulnar artery perforator flap in hand trauma. J Reconstr Microsurg, 2011, 27(9): 559-565.
5.	巨积辉, 金光哲, 李建宁, 等. 游离腹壁浅动脉筋膜穿支皮瓣修复手部创面. 中华手外科杂志, 2008, 24(3): 160-161.
6.	许亚军, 寿奎水, 芮永军, 等. 急诊组织瓣移植(位)修复伴有严重血管损伤的上肢复杂性组织缺损. 中华手外科杂志, 2010, 26(1): 7-10.
7.	杨晓荣, 孟泽祖, 康彦文, 等. 游离穿支皮瓣修复手部软组织缺损61例. 中华显微外科杂志, 2010, 33(1): 84.
8.	高凤梅, 苏红青. 髂腹股沟皮瓣修复高龄手部皮肤缺损13例报告. 实用骨科杂志, 2010, 16(1): 56-57.
9.	章祥洲, 袁振奋, 李勇, 等. 旋髂浅动脉岛状皮瓣修复手部软组织缺损. 蚌埠医学院学报, 2009, 34(4): 216-217.
10.	陈天新, 吕松岑, 关德宏, 等. 腹部带蒂皮瓣设计改进及临床应用. 中国修复重建外科杂志, 2005, 19(2): 133-135.
11.	黄书润, 刘江涛. 带蒂皮瓣蒂部及供瓣区处理方法的改进. 中国现代手术学杂志, 2011, 15(5): 381-383.
12.	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. 中华手外科杂志, 2000, 16(3): 130-135.
13.	侯春林. 手部皮肤缺损的皮瓣修复. 中华手外科杂志, 2009, 25(2): 67.
14.	Jokuszies A, Niederbichler AD, Hirsch N, et al. The pedicled groin flap for defect closure of the hand. Oper Orthop Traumatol, 2010, 22(4): 440-451.
15.	Buchman SJ, Eglseder WA Jr, Robertson BC. Pedicled groin flaps for upper-extremity reconstruction in the elderly: a report of 4 cases. Arch Phys Med Rehabil, 2002, 83(6): 850-854.
16.	Ting JW, Rozen WM, Chubb D, et al. Improving the utility and reliability of the deep circumflex iliac artery perforator flap: the use of preoperative planning with CT angiography. Microsurgery, 2011, 31(8): 603-609.
17.	许亚军, 寿奎水, 芮永军, 等. 以旋髂深动脉及肌皮穿支供血的髂骨皮瓣移植修复四肢复合组织缺损. 中华显微外科杂志, 2009, 32(5): 400-401.
18.	中华医学会外科学会疝和腹壁外科学组. 腹部手术切口疝手术治疗方案(草案). 中华普通外科杂志, 2004, 19(2): 125.

1. 阳运康, 鲁晓波, 张忠杰, 等. 带蒂尺动脉腕上皮支皮瓣修复对侧手指脱套伤. 中国修复重建外科杂志, 2011, 25(2): 202-205.
2. 林涧, 郑和平. 前臂后外侧中段穿支皮瓣的临床应用. 中华显微外科杂志, 2010, 33(6): 490-491.
3. 齐杰, 李雯, 刘艳杰, 等. 前臂外侧皮神经营养血管逆行蒂岛状皮瓣修复手背软组织缺损. 中华整形外科杂志, 2010, 26(4): 241-243.
4. Unal C, Ozdemir J, Hasdemir M. Clinical application of distal ulnar artery perforator flap in hand trauma. J Reconstr Microsurg, 2011, 27(9): 559-565.
5. 巨积辉, 金光哲, 李建宁, 等. 游离腹壁浅动脉筋膜穿支皮瓣修复手部创面. 中华手外科杂志, 2008, 24(3): 160-161.
6. 许亚军, 寿奎水, 芮永军, 等. 急诊组织瓣移植(位)修复伴有严重血管损伤的上肢复杂性组织缺损. 中华手外科杂志, 2010, 26(1): 7-10.
7. 杨晓荣, 孟泽祖, 康彦文, 等. 游离穿支皮瓣修复手部软组织缺损61例. 中华显微外科杂志, 2010, 33(1): 84.
8. 高凤梅, 苏红青. 髂腹股沟皮瓣修复高龄手部皮肤缺损13例报告. 实用骨科杂志, 2010, 16(1): 56-57.
9. 章祥洲, 袁振奋, 李勇, 等. 旋髂浅动脉岛状皮瓣修复手部软组织缺损. 蚌埠医学院学报, 2009, 34(4): 216-217.
10. 陈天新, 吕松岑, 关德宏, 等. 腹部带蒂皮瓣设计改进及临床应用. 中国修复重建外科杂志, 2005, 19(2): 133-135.
11. 黄书润, 刘江涛. 带蒂皮瓣蒂部及供瓣区处理方法的改进. 中国现代手术学杂志, 2011, 15(5): 381-383.
12. 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. 中华手外科杂志, 2000, 16(3): 130-135.
13. 侯春林. 手部皮肤缺损的皮瓣修复. 中华手外科杂志, 2009, 25(2): 67.
14. Jokuszies A, Niederbichler AD, Hirsch N, et al. The pedicled groin flap for defect closure of the hand. Oper Orthop Traumatol, 2010, 22(4): 440-451.
15. Buchman SJ, Eglseder WA Jr, Robertson BC. Pedicled groin flaps for upper-extremity reconstruction in the elderly: a report of 4 cases. Arch Phys Med Rehabil, 2002, 83(6): 850-854.
16. Ting JW, Rozen WM, Chubb D, et al. Improving the utility and reliability of the deep circumflex iliac artery perforator flap: the use of preoperative planning with CT angiography. Microsurgery, 2011, 31(8): 603-609.
17. 许亚军, 寿奎水, 芮永军, 等. 以旋髂深动脉及肌皮穿支供血的髂骨皮瓣移植修复四肢复合组织缺损. 中华显微外科杂志, 2009, 32(5): 400-401.
18. 中华医学会外科学会疝和腹壁外科学组. 腹部手术切口疝手术治疗方案(草案). 中华普通外科杂志, 2004, 19(2): 125.

Chinese Journal of Reparative and Reconstructive Surgery

IMPROVED PEDICLED SUPERFICIAL ILIAC CIRCUMFLEX ARTERY FLAP FOR RECONSTRUCTION OF HAND AND FOREARM WOUNDS

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