Original Article · History and Future of Perforator Flaps
Clinical effects of dorsal perforator fascia pedicle flap of the deep palmar arch in the repair of skin and soft tissue defects of finger web area
Lin Jian, Zhang Tianhao, Hu Deqing, Wang Zhijiang, Liu Caiyue, Zheng Heping
Published 2019-07-20
Cite as Chin J Burns, 2019, 35(7): 490-494. DOI: 10.3760/cma.j.issn.1009-2587.2019.07.003
Abstract
ObjectiveTo explore the clinical effects of dorsal perforator fascia pedicle flap of the deep palmar arch in the repair of skin and soft tissue defects of finger web area.
MethodsEleven patients (7 males and 4 females, aged from 18 to 73 years) with soft tissue defects of finger web area in distal dorsal side were admitted to Xinhua Hospital (Chongming) of Shanghai Jiao Tong University School of Medicine from October 2010 to September 2018. The sizes of skin and soft tissue defects ranged from 2.5 cm×1.5 cm to 6.0 cm×2.5 cm. According to the origin, course, branches, and distribution of the dorsal perforator of deep palmar arch, and the anatomical characteristics with vascular network of dorsal carpal and dorsal metacarpal, dorsal perforator fascia pedicle flaps of the deep palmar arch from the back of the injured hands were designed and transferred to repair the wounds of finger web area in distal dorsal side. The sizes of the flaps of patients ranged from 3.5 cm×2.0 cm to 6.5 cm×3.0 cm. The donor sites were sutured directly or covered with free forearm full-thickness skin graft. The clinical effects and swelling degree of flaps in early and late stages were evaluated during the follow-up of 3 to 36 months post surgery.
ResultsAll the flaps survived in 11 patients, the incisions in donor and recipient sites were healed. During the follow-up of 3 to 36 months post surgery, the survival of flaps was good, and the appearance, color, and elasticity were close to normal skin, with two-point discrimination distance of 7 to 10 mm and sensory function recovery of grade S3. The wounds in donor site had small scar without infection. The efficacy was evaluated as satisfactory in 8 patients, general in 3 patients, and dissatisfactory in no patient. Flap swelling rating in early stage was 1st degree in 7 patients, 2nd degree in 2 patients, and 3rd degree in 2 patients. Flap swelling rating in late stage was 1st degree in 8 patients, 2nd degree in 2 patients, and 3rd degree in 1 patient. The extension and flexion of the metacarpal and interphalangeal joints were basically normal and the patients were satisfied with the outcomes.
ConclusionsBased on the dorsal perforator of deep palmar arch, dorsal perforator fascia pedicle flap of the deep palmar arch is reliable to transfer to repair skin and soft tissue defects of finger web area in distal dorsal side, which is worthy of promotion in clinic.
Key words:
Surgical flaps; Deep palmar arch; Perforator; Tissue defects; Repair
Contributor Information
Lin Jian
Department of Orthopaedics, Xinhua Hospital (Chongming), Shanghai Jiao Tong University School of Medicine, Shanghai 202150, China
Zhang Tianhao
Department of Orthopaedics, Xinhua Hospital (Chongming), Shanghai Jiao Tong University School of Medicine, Shanghai 202150, China
Hu Deqing
Department of Orthopaedics, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350000, China
Wang Zhijiang
Department of Orthopaedics, Xinhua Hospital (Chongming), Shanghai Jiao Tong University School of Medicine, Shanghai 202150, China
Liu Caiyue
Department of Burns and Plastic Surgery, Shanghai Changzheng Hospital, Shanghai 200003, China
Zheng Heping
Department of Comparative Medicine, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, China
