CLINICAL APPLICATION OF REPAIRING WOUND IN WRIST WITH FLAP SUPPORTED BY PERFORATING BRANCH OF FOREARM RADIAL ARTERY AND CATENA-FORM BLOOD VESSEL_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUPeng ,  TANGXiujun , WEIZairong , WANGDali , SUNGuangfeng , WANGBaoyun , ZANQin

Department of Burns and Plastic Surgery, the Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563000, P. R. China;

Corresponding author：

TANGXiujun, Email: xiujunsszx@163.com

Keywords：

Perforator flap; Superior wrist perforator of radial artery; Catena-form blood vessel; Wound repair

DOI：

10.7507/1002-1892.20140110

Video：

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Objective To explore the clinical application of the flap supported by perforating branch of the radial artery superior wrist catena-form blood vessel in repairing hand and wrist wound. Methods Between March 2010 and March 2013, 24 cases of severe wounds in wrist were repaired with the flap supported by perforating branch of forearm radial artery and catena-form blood vessel. There were 15 males and 9 females, aged 19-54 years (mean, 37 years). In 22 patients with trauma, there were 9 cases of machine injury, 5 cases of traffic accident injury, 5 cases of crash injury of heavy objects, 1 case of sharp instrument injury, and 2 cases of electrical injury, with a mean disease duration of 11 days (range, 2-20 days). In 2 patients with tumor excision wound, there were 1 case of right forearm liposarcoma and 1 case of left forearm squamous-cell carcinoma, with the disease duration of 7 days and 3 months, respectively. All cases complicated by bone and tendon exposure. The size of defect was 4.5 cm×4.0 cm to 10.0 cm×7.5 cm, and the size of the flap was 6.0 cm×4.0 cm to 20.0 cm×8.5 cm. The donor site was directly sutured or repaired by skin graft. Results Partial flap necrosis occurred in 1 case, and was cured after dressing change; the other flaps survived, and primary healing of incision was obtained. The patients were followed up 6-36 months (mean, 20 months). The flap featured good color and texture, and also recovered protective sensation at 6 months after operation, with a mean two-point discrimination of 12 mm (range, 11-14 mm). No ulcers of the flap was observed. At last follow-up, according to Hand Surgery Society of Chinese Medical Association for functional evaluation of upper limb, the function was rated as excellent in 19 cases, good in 4 cases, and fair in 1 case. Conclusion The flap supported by perforating branch of forearm radial artery and catena-form blood vessel can be used to repair wound in wrist, which has no injury to the radial artery, and it also could be used for the patients with ulnar and radial artery injuries. Thus it is an ideal method to repair wound in the wrist because the operation is simple, and the flap has good appearance and texture.

Citation： HUPeng, TANGXiujun, WEIZairong, WANGDali, SUNGuangfeng, WANGBaoyun, ZANQin. CLINICAL APPLICATION OF REPAIRING WOUND IN WRIST WITH FLAP SUPPORTED BY PERFORATING BRANCH OF FOREARM RADIAL ARTERY AND CATENA-FORM BLOOD VESSEL. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(4): 491-494. doi: 10.7507/1002-1892.20140110 Copy

1.	唐修俊, 魏在荣, 王波, 等. 改良带蒂旋髂浅动脉皮瓣修复手部及前臂创面. 中国修复重建外科杂志, 2012, 26(8):943-945.
2.	雷磊, 米增法, 孟红阳, 等. 桡动脉逆行岛状皮瓣修复手深度烧伤. 实用医学杂志, 2013, 29(2):330.
3.	杨卫玺, 李春江, 王一兵, 等. 游离上臂外侧皮瓣修复手部深度烧伤. 中华显微外科杂志, 2010, 33(5):436.
4.	Zhang YX, Qian Y, Pu Z, et al. Reverse bipaddle posterior interosseous artery perforator flap. Plast Reconstr Surg, 2013, 131(4):552e-562e.
5.	丁自海, 王增涛, 钟世镇. 皮瓣解剖学研究的三个阶段. 中华显微外科杂志, 2010, 33(3):180-181.
6.	索岩, 魏壮, 刘飙, 等. 桡动脉穿支皮瓣修复手及腕部皮肤缺损. 实用手外科杂志, 2012, 26(3):263-264.
7.	魏在荣, 郑和平, 王达利. 手足部皮瓣的解剖与临床应用. 天津:天津科学技术出版社, 2012:133-135, 151-154.
8.	谢庆平, 郭恩琪, 晋培红, 等. 改良桡动脉穿支皮瓣在修复额面部组织缺损中的应用. 中华显微外科杂志, 2010, 33(1):6-8.
9.	张世民, 顾玉东, 侯春林, 等. 腕部血管网的解剖基础及其与前臂远端蒂皮瓣的关系. 中国临床解剖学杂志, 2002, 20(5):345-347.
10.	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.
11.	张发惠, 郑和平. 构建3种低旋转轴点的前臂皮神经-浅静脉营养血管远端蒂复合瓣的解剖学实验. 中国临床康复, 2005, 9(46):79-83.
12.	Jeng SF, Wei FC. The distally based forealm island flap in hand reconstruction. Plast Reconstr Surg, 1998, 102(2):400-406.
13.	Chang SM. The pedicle of neurocutaneous island flaps. Plast Reconstr Surg, 1996, 98(2):374-376.
14.	张世民, 徐达传, 顾玉东, 等. 链型皮瓣的血管基础及临床意义. 中国临床解剖学杂志, 2004, 22(1):13-16.
15.	张世民, 唐茂林, 章伟文, 等. 中国穿支皮瓣的名词术语与临床应用原则共识(暂定稿). 中华显微外科杂志, 2012, 35(2):89-92.
16.	Mateev MA, Ogawa R, Trunov L, et al. Shape-modified radial artery perforator flap method:analysis of 112 cases. Plast Reconstr Surg, 2009, 123(5):1533-1542.
17.	李泽龙, 谢逸波, 曾波, 等. 贵要静脉-前臂内侧皮神经营养血管皮瓣的临床应用. 中华显微外科杂志, 2006, 29(1):68-69.
18.	唐修俊, 周信荣, 祁建平, 等. 三面会师法切取胫后动脉高位穿支蒂皮瓣修复小腿中下段骨外露. 遵义医学院学报, 2011, 34(5):512-514.

1. 唐修俊, 魏在荣, 王波, 等. 改良带蒂旋髂浅动脉皮瓣修复手部及前臂创面. 中国修复重建外科杂志, 2012, 26(8):943-945.
2. 雷磊, 米增法, 孟红阳, 等. 桡动脉逆行岛状皮瓣修复手深度烧伤. 实用医学杂志, 2013, 29(2):330.
3. 杨卫玺, 李春江, 王一兵, 等. 游离上臂外侧皮瓣修复手部深度烧伤. 中华显微外科杂志, 2010, 33(5):436.
4. Zhang YX, Qian Y, Pu Z, et al. Reverse bipaddle posterior interosseous artery perforator flap. Plast Reconstr Surg, 2013, 131(4):552e-562e.
5. 丁自海, 王增涛, 钟世镇. 皮瓣解剖学研究的三个阶段. 中华显微外科杂志, 2010, 33(3):180-181.
6. 索岩, 魏壮, 刘飙, 等. 桡动脉穿支皮瓣修复手及腕部皮肤缺损. 实用手外科杂志, 2012, 26(3):263-264.
7. 魏在荣, 郑和平, 王达利. 手足部皮瓣的解剖与临床应用. 天津:天津科学技术出版社, 2012:133-135, 151-154.
8. 谢庆平, 郭恩琪, 晋培红, 等. 改良桡动脉穿支皮瓣在修复额面部组织缺损中的应用. 中华显微外科杂志, 2010, 33(1):6-8.
9. 张世民, 顾玉东, 侯春林, 等. 腕部血管网的解剖基础及其与前臂远端蒂皮瓣的关系. 中国临床解剖学杂志, 2002, 20(5):345-347.
10. 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.
11. 张发惠, 郑和平. 构建3种低旋转轴点的前臂皮神经-浅静脉营养血管远端蒂复合瓣的解剖学实验. 中国临床康复, 2005, 9(46):79-83.
12. Jeng SF, Wei FC. The distally based forealm island flap in hand reconstruction. Plast Reconstr Surg, 1998, 102(2):400-406.
13. Chang SM. The pedicle of neurocutaneous island flaps. Plast Reconstr Surg, 1996, 98(2):374-376.
14. 张世民, 徐达传, 顾玉东, 等. 链型皮瓣的血管基础及临床意义. 中国临床解剖学杂志, 2004, 22(1):13-16.
15. 张世民, 唐茂林, 章伟文, 等. 中国穿支皮瓣的名词术语与临床应用原则共识(暂定稿). 中华显微外科杂志, 2012, 35(2):89-92.
16. Mateev MA, Ogawa R, Trunov L, et al. Shape-modified radial artery perforator flap method:analysis of 112 cases. Plast Reconstr Surg, 2009, 123(5):1533-1542.
17. 李泽龙, 谢逸波, 曾波, 等. 贵要静脉-前臂内侧皮神经营养血管皮瓣的临床应用. 中华显微外科杂志, 2006, 29(1):68-69.
18. 唐修俊, 周信荣, 祁建平, 等. 三面会师法切取胫后动脉高位穿支蒂皮瓣修复小腿中下段骨外露. 遵义医学院学报, 2011, 34(5):512-514.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF REPAIRING WOUND IN WRIST WITH FLAP SUPPORTED BY PERFORATING BRANCH OF FOREARM RADIAL ARTERY AND CATENA-FORM BLOOD VESSEL

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