CLINICAL APPLICATION OF RADIAL MID-FOREARM PERFORATOR FASCIOCUTANEOUS FLAP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 XIEYun ¹ , LINJianhua ¹ , YEJunjian ¹ , ZHENGHeping ²

1. Department of Orthopaedics, the First Clinical Medical Hospital of Fujian Medical University, Fuzhou Fujian, 350005, P. R. China;
2. Department of Comparative Medicine, Fuzhou General Hospital of Nanjing Military Command;

Corresponding author：

XIEYun, Email: xyxlr@126.com

Keywords：

Radial mid-forearm perforator fasciocutaneous flap; Soft tissue defect of the forearm; Wound repair

DOI：

10.7507/1002-1892.20140296

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of using radial mid-forearm perforator fasciocutaneous flap to repair soft tissue defect in lower segment of the forearm and the wrist. Methods Between May 2007 and July 2012, 7 cases of soft tissue defect of lower segment of the forearm and the wrist were repaired with radial mid-forearm perforator fasciocutaneous flap. There were 6 males and 1 female with an average age of 38 years (range, 22-45 years). Defects were caused by crushing injury in 4 cases with the disease duration of 3-22 days (mean, 14 days), by internal fixation of ulnar comminuted fracture in 2 cases after 16 and 20 days of operation respectively, and by focal cleaning of wrist joint tuberculosis in 1 cases after 24 days of operation. The locations of defect were the lower segment of the forearm in 5 cases and the dorsal side of the wrist in 2 cases. The area of soft tissue defect ranged from 4 cm×3 cm to 9 cm×5 cm. The size of flap ranged from 6 cm×4 cm to 12 cm×6 cm. The donor site was closed with direct suturing or skin grafting. Results The intraoperative blood loss was 50-90 mL (mean, 64 mL); the operation time was 60-80 minutes (mean, 72 minutes). Six flaps survived with wound heal ing by first intention; partial flap necrosis occurred in 1 case, and delayed healing was obtained after dressing change. Skin grafting at donor sites survived with healing of incision by first intention. The patients were followed up 3-14 months (mean, 9 months). No ulcer or sinus tract was observed; all flaps showed a sl ightly swollen appearance and had normal color. Conclusion Radial mid-forearm perforator fasciocutaneous flap does not need to dissect the source of blood vessels due to constantly anatomical structure. It has the advantages of easy operation, rich blood supply, high survival rate, and satisfactory cl inical effect, so it is an important supplement of the other non-main vessel pedicle flaps to repair soft tissue defect in the lower segment of the forearm and the wrist.

Citation： XIEYun, LINJianhua, YEJunjian, ZHENGHeping. CLINICAL APPLICATION OF RADIAL MID-FOREARM PERFORATOR FASCIOCUTANEOUS FLAP. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(11): 1368-1371. doi: 10.7507/1002-1892.20140296 Copy

1.	张世民, 徐达传, 俞光荣, 等.穿支皮瓣的发展与临床应用进展.中国临床解剖学杂志, 2006, 24(3):228-231, 239.
2.	Tajsic N, Winkel R, Husum H. Distally based perforator flaps for reconstruction of post-traumatic defects of the lower leg and foot. A review of the anatomy and cl inical outcomes. Injury, 2014, 45(3):469-477.
3.	Maciel-Miranda A, Morris SF, Hallock GG. Local flaps, including pedicled perforator flaps:anatomy, technique, and applications. Plast Reconstr Surg, 2013, 131(6):896e-911e.
4.	谢昀, 陈振光, 张发惠, 等.桡动脉肌间隙支前臂桡侧中段皮瓣的应用解剖.中华显微外科杂志, 2005, 28(2):148-149.
5.	郑和平, 陈鹏, 洪发兰, 等.前臂后外侧中段穿支蒂皮神经营养血管皮瓣的应用解剖.中国临床解剖学杂志, 2010, 28(4):358-362.
6.	Mei J, Morris SF, Ji W, et al. An anatomic study of the dorsal forearm perforator flaps. Surg Radiol Anat, 2013, 35(8):695-700.
7.	陈启康, 侯致典, 王增涛, 等.桡动脉和尺动脉皮支链皮瓣的应用解剖.解剖学研究, 2009, 31(3):201-203, 207.
8.	赵民, 田德虎, 张英泽, 等.前臂远端蒂复合血管网皮瓣修复腕手部皮肤缺损.中国修复重建外科杂志, 2005, 19(12):1001-1003.
9.	庞水发, 常湘珍, 张方晨, 等.皮瓣移植临床应用应坚持原则.中华显微外科杂志, 2010, 33(1):1-2.
10.	张发惠, 郑和平, 田万成, 等.前臂外侧皮神经-头静脉营养血管远端蒂复合瓣的应用解剖.中国临床解剖学杂志, 2005, 23(2):118-121.
11.	林海滨, 林涧, 郑晓晖, 等.前臂内侧皮神经营养血管远端蒂皮瓣的临床应用.中国临床解剖学杂志, 2008, 26(3):335-337.
12.	金玉丹, 罗少军, 王绥江, 等.前臂外侧皮神经-头静脉及其营养血管筋膜皮瓣的临床应用.中华显微外科杂志, 2008, 31(1):60-61.
13.	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.
14.	Hekner DD, Abbink JH, van Es RJ, et al. Donor-site morbidity of the radial forearm free flap versus the ulnarforearm free flap. Plast Reconstr Surg, 2013, 132(2):387-393.
15.	胡鹏, 唐修俊, 魏在荣, 等.前臂桡动脉腕上穿支链状供血皮瓣修复手腕部创面的临床应用.中国修复重建外科杂志, 2014, 28(4):491-494.
16.	林涧, 郑和平, 余云兰, 等.骨间后动脉远端皮支链皮瓣移位修复手背皮肤缺损.中华显微外科杂志, 2012, 35(5):421-422.
17.	卜凡玉, 薛明宇, 芮永军, 等.改良前臂骨间背侧动脉逆行岛状皮瓣修复手背部皮肤缺损疗效观察.中国修复重建外科杂志, 2014, 28(2):237-240.

1. 张世民, 徐达传, 俞光荣, 等.穿支皮瓣的发展与临床应用进展.中国临床解剖学杂志, 2006, 24(3):228-231, 239.
2. Tajsic N, Winkel R, Husum H. Distally based perforator flaps for reconstruction of post-traumatic defects of the lower leg and foot. A review of the anatomy and cl inical outcomes. Injury, 2014, 45(3):469-477.
3. Maciel-Miranda A, Morris SF, Hallock GG. Local flaps, including pedicled perforator flaps:anatomy, technique, and applications. Plast Reconstr Surg, 2013, 131(6):896e-911e.
4. 谢昀, 陈振光, 张发惠, 等.桡动脉肌间隙支前臂桡侧中段皮瓣的应用解剖.中华显微外科杂志, 2005, 28(2):148-149.
5. 郑和平, 陈鹏, 洪发兰, 等.前臂后外侧中段穿支蒂皮神经营养血管皮瓣的应用解剖.中国临床解剖学杂志, 2010, 28(4):358-362.
6. Mei J, Morris SF, Ji W, et al. An anatomic study of the dorsal forearm perforator flaps. Surg Radiol Anat, 2013, 35(8):695-700.
7. 陈启康, 侯致典, 王增涛, 等.桡动脉和尺动脉皮支链皮瓣的应用解剖.解剖学研究, 2009, 31(3):201-203, 207.
8. 赵民, 田德虎, 张英泽, 等.前臂远端蒂复合血管网皮瓣修复腕手部皮肤缺损.中国修复重建外科杂志, 2005, 19(12):1001-1003.
9. 庞水发, 常湘珍, 张方晨, 等.皮瓣移植临床应用应坚持原则.中华显微外科杂志, 2010, 33(1):1-2.
10. 张发惠, 郑和平, 田万成, 等.前臂外侧皮神经-头静脉营养血管远端蒂复合瓣的应用解剖.中国临床解剖学杂志, 2005, 23(2):118-121.
11. 林海滨, 林涧, 郑晓晖, 等.前臂内侧皮神经营养血管远端蒂皮瓣的临床应用.中国临床解剖学杂志, 2008, 26(3):335-337.
12. 金玉丹, 罗少军, 王绥江, 等.前臂外侧皮神经-头静脉及其营养血管筋膜皮瓣的临床应用.中华显微外科杂志, 2008, 31(1):60-61.
13. 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.
14. Hekner DD, Abbink JH, van Es RJ, et al. Donor-site morbidity of the radial forearm free flap versus the ulnarforearm free flap. Plast Reconstr Surg, 2013, 132(2):387-393.
15. 胡鹏, 唐修俊, 魏在荣, 等.前臂桡动脉腕上穿支链状供血皮瓣修复手腕部创面的临床应用.中国修复重建外科杂志, 2014, 28(4):491-494.
16. 林涧, 郑和平, 余云兰, 等.骨间后动脉远端皮支链皮瓣移位修复手背皮肤缺损.中华显微外科杂志, 2012, 35(5):421-422.
17. 卜凡玉, 薛明宇, 芮永军, 等.改良前臂骨间背侧动脉逆行岛状皮瓣修复手背部皮肤缺损疗效观察.中国修复重建外科杂志, 2014, 28(2):237-240.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF RADIAL MID-FOREARM PERFORATOR FASCIOCUTANEOUS FLAP

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content