EFFECTIVENESS OF IMPROVED INTEROSSEOUS DORSAL ARTERY REVERSED ISLAND FLAP FOR DORSAL SKIN AND SOFT TISSUE DEFECT OF HAND_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 BUFanyu , XUEMingyu , RUIYongjun , GULiming , SHOUKuishui , QIANGLi , ZHOUXiao

Department of Hand Surgery, Wuxi 9th People's Hospital, Wuxi Hand Surgery Hospital, Wuxi Jiangsu, 214062, P. R. China;

Corresponding author：

BUFanyu, Email: bufanyu1020@163.com

Keywords：

Improved interosseous dorsal artery reversed island flap; Dorsal soft tissue defect of hand; Wound repair

DOI：

10.7507/1002-1892.20140051

Video：

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Objective To discuss the effectiveness of improved interosseous dorsal artery reversed island flap to repair dorsal skin and soft tissue defect of the hand. Methods Between March 2009 and September 2012, 29 cases of dorsal skin and soft tissue defects were treated with improved interosseous dorsal artery reversed island flap. Of 29 cases, there were 17 males and 12 females, aged 23-71 years (mean, 47 years); and the left hand was involved in 12 cases and the right hand in 17 cases. There were 11 cases of avulsion injury, 9 cases of crushing injury, 5 cases of strangulation injury, and 2 cases of traffic accident injury; the interval of injury and admission was 1-7 hours (mean, 4 hours). Two patients had scar contracture. The locations of soft tissue defects were dorsal hands in 21 cases, first webs in 5 cases, and dorsal thumb in 3 cases. The size of soft tissue defects ranged from 4 cm×3 cm to 10 cm×8 cm. One-stage repair was performed in 11 cases, and two-stage repair in 18 cases. The size of flaps ranged from 5.5 cm×4.5 cm to 12.0 cm×10.0 cm. The donor sites were sutured directly or repaired by skin grafting. Results All flaps survived, and wounds healed in first stage. And the grafted skins at donor sites all survived, and incisions all healed in first stage. Twenty-six patients were followed up 3 months-3 years (mean, 19.5 months). Bulky flap was observed in 3 cases, and defatted operation was performed after 6 months; the other flaps had good appearance and texture, and wrist function was normal. According to total angle of motion (TAM) systematic evaluation, the results were excellent in 17 cases, good in 6 cases, and fair in 3 cases at 3 months after operation. Conclusion Improved interosseous dorsal artery reversed island flap has the advantages of easy-to-obtain, simple operation, and high survival rate of flaps, so it is an effective method to repair dorsal skin and soft tissue defect of the hand.

Citation： BUFanyu, XUEMingyu, RUIYongjun, GULiming, SHOUKuishui, QIANGLi, ZHOUXiao. EFFECTIVENESS OF IMPROVED INTEROSSEOUS DORSAL ARTERY REVERSED ISLAND FLAP FOR DORSAL SKIN AND SOFT TISSUE DEFECT OF HAND. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(2): 237-240. doi: 10.7507/1002-1892.20140051 Copy

1.	孙振中,寿奎水,张全荣,等.前臂骨间背动脉逆行岛状皮瓣修复手部创伤.实用手外科杂志,2003,17(4):249.
2.	张志海,寿奎水,张全荣,等.改良前臂骨间后动脉逆行岛状皮瓣修复手部皮肤缺损.交通医学,2007,21(5):564.
3.	许亚军,孙振中,张志海,等.背侧骨间动脉逆行岛状皮瓣皮支血管的临床分型及应用体会.实用手外科杂志,2010,24(3):175-177.
4.	汤金城.手背软组织缺损的显微外科修复.实用手外科杂志,2006,20(2):113.
5.	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.
6.	张世民,顾玉东,侯春林.皮瓣外科的研究进展.国外医学:骨科学分册,2002,23(1):3-6.
7.	李昶,白志刚,王润生,等.前臂背侧皮动脉逆行岛状皮瓣的解剖与应用.中华骨科杂志,2005,25(4):211-213.
8.	Penteado CV,Masquelet AC,Cheverl JP.The anatomic basis of the fascio-xutaneous flap of the posterior interosseous artery.Surg Radiol Anat,1986,8(4):209-215.
9.	潘朝辉,蒋萍萍.前臂骨间背侧血管变异1例.解剖与临床,2002,7(3):117.
10.	吴学军,夏英慧,林向全,等.前臂骨间背动脉皮瓣修复手指掌侧皮肤缺损.中华显微外科杂志,2007,30(3):213-214.
11.	Chen WL,Yang ZH,Huang ZQ,et al.Facial contour reconstruction after benign tumor ablation using reverse facial-submental artery deepithelialized submental island flaps.J Craniofac Surg,2010,21(1):83-86.
12.	Hallock GG.A paradigm shift for soft-tissue coverage of the zones of the abdominal wall using perforator flaps.Plast Reconstr Surg,2012,130(3):590-599.
13.	王欣,潘佳栋,陈宏,等.骨间后动脉近端穿支皮瓣游离移植修复手部软组织缺损.中华整形外科杂志,2012,28(2):83-87.
14.	Demiralp CÖ,Akkaya H,Duman Y,et al.Reconstruction of traumatic lower extremity soft tissue defects with the combination of ipsilateral and contralateral perforator flaps.Int J Low Extrem Wounds,2012,11(4):304-306.

1. 孙振中,寿奎水,张全荣,等.前臂骨间背动脉逆行岛状皮瓣修复手部创伤.实用手外科杂志,2003,17(4):249.
2. 张志海,寿奎水,张全荣,等.改良前臂骨间后动脉逆行岛状皮瓣修复手部皮肤缺损.交通医学,2007,21(5):564.
3. 许亚军,孙振中,张志海,等.背侧骨间动脉逆行岛状皮瓣皮支血管的临床分型及应用体会.实用手外科杂志,2010,24(3):175-177.
4. 汤金城.手背软组织缺损的显微外科修复.实用手外科杂志,2006,20(2):113.
5. 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.
6. 张世民,顾玉东,侯春林.皮瓣外科的研究进展.国外医学:骨科学分册,2002,23(1):3-6.
7. 李昶,白志刚,王润生,等.前臂背侧皮动脉逆行岛状皮瓣的解剖与应用.中华骨科杂志,2005,25(4):211-213.
8. Penteado CV,Masquelet AC,Cheverl JP.The anatomic basis of the fascio-xutaneous flap of the posterior interosseous artery.Surg Radiol Anat,1986,8(4):209-215.
9. 潘朝辉,蒋萍萍.前臂骨间背侧血管变异1例.解剖与临床,2002,7(3):117.
10. 吴学军,夏英慧,林向全,等.前臂骨间背动脉皮瓣修复手指掌侧皮肤缺损.中华显微外科杂志,2007,30(3):213-214.
11. Chen WL,Yang ZH,Huang ZQ,et al.Facial contour reconstruction after benign tumor ablation using reverse facial-submental artery deepithelialized submental island flaps.J Craniofac Surg,2010,21(1):83-86.
12. Hallock GG.A paradigm shift for soft-tissue coverage of the zones of the abdominal wall using perforator flaps.Plast Reconstr Surg,2012,130(3):590-599.
13. 王欣,潘佳栋,陈宏,等.骨间后动脉近端穿支皮瓣游离移植修复手部软组织缺损.中华整形外科杂志,2012,28(2):83-87.
14. Demiralp CÖ,Akkaya H,Duman Y,et al.Reconstruction of traumatic lower extremity soft tissue defects with the combination of ipsilateral and contralateral perforator flaps.Int J Low Extrem Wounds,2012,11(4):304-306.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF IMPROVED INTEROSSEOUS DORSAL ARTERY REVERSED ISLAND FLAP FOR DORSAL SKIN AND SOFT TISSUE DEFECT OF HAND

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