CLINICAL APPLICATION OF FOREARM INTEROSSEOUS DORSAL ARTERY PERFORATOR SUBLOBE FLAPS TO REPAIR TWO WOUNDS IN DORSAL HAND OR WRIST_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANGBaoyun ,  TANGXiujun , WEIZairong , WANGDali , SUNGuangfeng , WANGBo , QIJianping , JINWenhu

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：

Forearm interosseous dorsal artery perforator; Sublobe flap; Dorsal hand; Wrist; Multiple wounds; Wound repair

DOI：

10.7507/1002-1892.20140111

Video：

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Objective To investigate the clinical application of the forearm interosseous dorsal artery perforator sublobe flaps in repairing two wounds in dorsal hand or wrist. Methods Between October 2009 and October 2012, 12 patients with two wounds in the dorsal hand or wrist were included in the study. There were 4 cases of skin defects (grade IV) and bone exposure caused by machine injury, 3 cases of skin defects with bone and tendon exposure caused by traffic accident, and 3 cases of skin defect and tendon exposure caused by crash injury of heavy object, with a duration of 3-12 hours (mean, 6 hours) between injury and admission; defects in the wrist and tendon exposure were caused by tumor resection in 2 cases. Four cases had metacarpal fractures. The size of larger skin and soft tissue defects ranged from 4.0 cm×3.5 cm to 5.0 cm×3.0 cm, and the size of smaller defects was from 2.5 cm×2.0 cm to 4.0 cm×3.0 cm. The flap size was from 6 cm×4 cm to 8 cm×3 cm and 3.0 cm×2.5 cm to 5.0 cm×3.0 cm. The donor sites were directly sutured or repaired with free skin graft. Results All the flaps survived, and wound healed in first stage. All the cases were followed up 6-36 months (mean, 20 months). The flaps had good color and texture. Three cases underwent secondary surgery of thinning the flaps. At last follow-up, two-point discrimination of flaps was 10-14 mm, 12 mm on average. According to function standard for evaluation of upper extremity with total active motion of the fingers from the Hand Surgery Society of Chinese Medical Association, the results were excellent in 10 cases, and good in 2 cases. Conclusion Forearm interosseous dorsal artery perforators sublobe flaps can be used to repair two wounds in the dorsal hand or wrist simultaneously, and it has the advantages of simple operation, less injury at donor site, and reliable blood supply.

Citation： WANGBaoyun, TANGXiujun, WEIZairong, WANGDali, SUNGuangfeng, WANGBo, QIJianping, JINWenhu. CLINICAL APPLICATION OF FOREARM INTEROSSEOUS DORSAL ARTERY PERFORATOR SUBLOBE FLAPS TO REPAIR TWO WOUNDS IN DORSAL HAND OR WRIST. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(4): 495-498. doi: 10.7507/1002-1892.20140111 Copy

1.	宋铁山, 李鸿文, 彭云滔, 等. 应用骨间背侧肌皮瓣修复手部创面. 中华显微外科杂志, 2012, 35(1):55-56.
2.	高建明, 刘云鹏, 李宏, 等. 皮瓣修复在手外科临床应用277例报道. 实用手外科杂志, 2010, 24(2):114-115.
3.	戚建武, 柴益铜, 王科杰, 等. 游离腹股沟皮瓣修复手部皮肤缺损. 中华手外科杂志, 2013, 29(5):271-273.
4.	郭晓波, 苏薇洁, 朱文, 等. 前臂背侧骨间动脉穿支逆行岛状皮瓣修复手部皮肤和软组织缺损. 上海交通大学学报:医学版, 2011, 31(7):992-995.
5.	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):512-515.
6.	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.
7.	魏在荣, 郑和平, 王达利, 等. 手足部皮瓣的解剖与临床应用. 天津:天津科学技术出版社, 2011:102-103.
8.	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.
9.	Costa H, Pinto A, Zenha H. The posterior interosseous flap-a prime technique in hand reconstruction. The experience of 100 anatomical dissections and 102 clinical cases. J Plast Reconstr Aesthet Surg, 2007, 60(7):740-747.
10.	Giunta R, Lukas B. Impossible harvest of the posterior interosseous artery flap:a report of an individualised salvage procedure. Br J Plast Surg, 1998, 51(8):642-645.
11.	Kola N, Isaraj S, Xhepa G, et al. Posterior interosseous forearm flap in reconstruction of first web space. Ann Burns Fire Disas, 2009, 22(2):104-106.
12.	王欣, 胡浩良, 王胜伟, 等. 前臂骨间后动脉穿支皮瓣的解剖学研究. 解剖与临床, 2011, 16(1):69-70.
13.	吕乾, 朱跃良, 梅良斌, 等. 前臂骨间背侧动脉穿支游离皮瓣修复手指创面. 创伤外科杂志, 2011, 14(4):324-325.
14.	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.
15.	王宝云, 唐修俊, 魏在荣, 等. 改良肋间动脉穿支蒂胸腹部皮瓣修复前臂创面. 中国修复重建外科杂志, 2014, 28(1):125-126.
16.	Akinci M, Ay S, Kamiloglu S, et al. The reverse posterior interosseous flap:a solution for necrosis based on a review of 87 case. J Plast Reconstr Aesthet Surg, 2006, 59(2):148-152.
17.	闫涛, 黎立, 乔为民, 等. 前臂骨间背侧动脉逆行岛状皮瓣修复手部创面. 中国修复重建外科杂志, 2011, 25(3):377-378.

1. 宋铁山, 李鸿文, 彭云滔, 等. 应用骨间背侧肌皮瓣修复手部创面. 中华显微外科杂志, 2012, 35(1):55-56.
2. 高建明, 刘云鹏, 李宏, 等. 皮瓣修复在手外科临床应用277例报道. 实用手外科杂志, 2010, 24(2):114-115.
3. 戚建武, 柴益铜, 王科杰, 等. 游离腹股沟皮瓣修复手部皮肤缺损. 中华手外科杂志, 2013, 29(5):271-273.
4. 郭晓波, 苏薇洁, 朱文, 等. 前臂背侧骨间动脉穿支逆行岛状皮瓣修复手部皮肤和软组织缺损. 上海交通大学学报:医学版, 2011, 31(7):992-995.
5. 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):512-515.
6. 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.
7. 魏在荣, 郑和平, 王达利, 等. 手足部皮瓣的解剖与临床应用. 天津:天津科学技术出版社, 2011:102-103.
8. 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.
9. Costa H, Pinto A, Zenha H. The posterior interosseous flap-a prime technique in hand reconstruction. The experience of 100 anatomical dissections and 102 clinical cases. J Plast Reconstr Aesthet Surg, 2007, 60(7):740-747.
10. Giunta R, Lukas B. Impossible harvest of the posterior interosseous artery flap:a report of an individualised salvage procedure. Br J Plast Surg, 1998, 51(8):642-645.
11. Kola N, Isaraj S, Xhepa G, et al. Posterior interosseous forearm flap in reconstruction of first web space. Ann Burns Fire Disas, 2009, 22(2):104-106.
12. 王欣, 胡浩良, 王胜伟, 等. 前臂骨间后动脉穿支皮瓣的解剖学研究. 解剖与临床, 2011, 16(1):69-70.
13. 吕乾, 朱跃良, 梅良斌, 等. 前臂骨间背侧动脉穿支游离皮瓣修复手指创面. 创伤外科杂志, 2011, 14(4):324-325.
14. 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.
15. 王宝云, 唐修俊, 魏在荣, 等. 改良肋间动脉穿支蒂胸腹部皮瓣修复前臂创面. 中国修复重建外科杂志, 2014, 28(1):125-126.
16. Akinci M, Ay S, Kamiloglu S, et al. The reverse posterior interosseous flap:a solution for necrosis based on a review of 87 case. J Plast Reconstr Aesthet Surg, 2006, 59(2):148-152.
17. 闫涛, 黎立, 乔为民, 等. 前臂骨间背侧动脉逆行岛状皮瓣修复手部创面. 中国修复重建外科杂志, 2011, 25(3):377-378.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF FOREARM INTEROSSEOUS DORSAL ARTERY PERFORATOR SUBLOBE FLAPS TO REPAIR TWO WOUNDS IN DORSAL HAND OR WRIST

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