FREE CROIN FLAP FOR REPAIRING DEFECTS OF DONOR AFTER TOE TISSUE TRANS PLANTATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIMuwei , LUOZhaohui , GUHannan , MALifeng , YANGYanjun ,  ZHANGZiqing

Department of Hand Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen Guangdong, 518116, P. R. China;

Corresponding author：

ZHANGZiqing, Email: Dr-zhangzq@sina.com

Keywords：

Donor site of feet; Croin flap; Wound repair

DOI：

10.7507/1002-1892.20160044

Video：

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Objective To discuss the effectiveness of free croin flap in repairing defects of donor after toe or feet tissue flap transplantation. Methods Between March 2010 and May 2015, 23 cases of defects of donor after toe or feet tissue flap transplantation were repaired with free croin flap and followed up for more than 6 months, and the clinical data were retrospectively analyzed. There were 15 males and 8 females, with an age range from 17 to 52 years (mean, 25.6 years). All finger or soft tissue defects were caused by trauma. Defects were repaired in emergency operation with toe or feet tissue flap transplantation in 18 cases, defects were secondarily reconstructed at 3-8 months after injury in 5 cases. The defect area at the feet donor site ranged from 3 cm×3 cm to 10 cm×6 cm, all accompanied with exposure of bone, and tendon. The area of free croin flap was 3.5 cm×3.5 cm-11.0 cm×6.5 cm, the vessel of flap was anastomosed with artery and vein of foot. The inguinal donor site was sutured directly. Results The operation time was 3-9 hours (mean, 4.5 hours); the intraoperative blood loss was 50-300 mL (mean, 120 mL). Vessel crisis occurred in 1 case postoperatively; mild and moderate swelling occurred in 3 cases, with small sporadic blisters formation; free croin flap survived completely in the other cases, and primary healing was obtained at feet wound and inguinal donor sites. Twenty-three cases were followed up 6-24 months (mean, 9 months). The color and texture of the croin flaps were similar to that of the adjacent skin, no obvious scar contracture and pigmentation were observed; the patient could walk with weight loading, the two-point discrimination was 18-35 mm (mean, 26 mm) at 6 months after operation. The color, texture, and shape of reconstructed finger was good; the function of grasping and pinching recovered well; the two-point discrimination was 5.5-11.0 mm (mean, 6.5 mm) at 6 months after operation. According to upper extremity functional evaluation standard by Chinese Medical Association, the results were excellent in 18 cases and good in 5 cases. Conclusion Free croin flap can effectively repair skin and soft tissue defects of donor after toe or feet tissue flap transplantation, and good function and appearance of feet can be obtained.

Citation： LIMuwei, LUOZhaohui, GUHannan, MALifeng, YANGYanjun, ZHANGZiqing. FREE CROIN FLAP FOR REPAIRING DEFECTS OF DONOR AFTER TOE TISSUE TRANS PLANTATION. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(2): 215-218. doi: 10.7507/1002-1892.20160044 Copy

1.	程国良. 不同形式的足趾移植拇手指再造与修复. 中华显微外科杂志, 2002, 25(1):8-9.
2.	孙广峰, 魏在荣, 王利达, 等. 趾腓侧皮瓣游离移植修复手指掌侧皮肤缺损. 中国修复重建外科杂志, 2011, 25(4):510-512.
3.	冯明录, 何勇, 董涛, 等. 拇指软组织缺损显微修复治疗方法分析. 中华显微外科杂志, 2010, 33(6):517-518.
4.	侍朋举, 张文龙, 赵刚, 等. 足背皮瓣串并联甲复合组织瓣修复手部脱套伤伴拇指缺损. 中国修复重建外科杂志, 2015, 29(7):799-803.
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.	仇申强, 王增涛, 孙文海, 等. 手指再造术中甲瓣供区的修复. 中华显微外科杂志, 2011, 34(4):272-275.
7.	王保山, 郑晓菊, 王新宏, 等. 甲瓣切取术后创面的处理. 中华显微外科杂志, 2009, 32(1):26-28.
8.	程鹏, 郑元波, 李丽. 四肢组织移植后供区继发损伤的处理方法探讨. 浙江创伤外科, 2011, 16(1):65-67.
9.	侯春林. 供求同重-提高我国组织移植修复缺损及功能重建水平. 中国修复重建外科杂志, 2005, 19(7):499-500.
10.	康庆林, 柴益民, 曾炳芳, 等. 甲瓣切取术后供区创面覆盖的方法选择. 中华显微外科杂志, 2007, 30(4):267-269.
11.	夏晓丹, 谢松林, 黄雄杰, 等. 股前外侧穿支皮瓣修复甲瓣再造拇指足供区皮肤缺损. 中国修复重建外科杂志, 2014, 28(1):127-128.
12.	姜晓华, 马合龙. 足拇甲瓣治疗单手指脱套伤并跗外侧皮瓣修复足供区. 中国美容医学, 2012, 21(7)下:60-61.
13.	李宗军, 肖春凌, 殷建新, 等. 腓动脉终末穿支蒂腓浅神经营养血管岛状皮瓣修复前足供区创面. 中国修复重建外科杂志, 2009, 23(2):209-211.
14.	郑艳峰, 沈晓霞, 朱家骏, 等. 腓浅神经营养血管皮瓣修复足部供区创面的临床应用. 中华显微外科杂志, 2013, 36(6):572-573.
15.	魏勇, 李钧, 童哲, 等. 跗外侧皮瓣修复甲皮瓣术中趾供区的创面. 中华手外科杂志, 2010, 26(5):318.
16.	杨庆达, 张智钊, 卢家灵, 等. 改良第一趾蹼皮瓣游离移植术后供区创面的修复. 中国修复重建外科杂志, 2013, 27(10):1279-1280.
17.	徐达传, 张世民, 唐茂林. 穿支皮瓣及相关术语的初步共识. 中华显微外科杂志, 2011, 34(5):358-359.
18.	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.
19.	Kimura N, Satoh K, Hosaka Y. Tensor fasciae latae perforator flap. Clin Plast Surg, 2003, 30(3):439-446.

1. 程国良. 不同形式的足趾移植拇手指再造与修复. 中华显微外科杂志, 2002, 25(1):8-9.
2. 孙广峰, 魏在荣, 王利达, 等. 趾腓侧皮瓣游离移植修复手指掌侧皮肤缺损. 中国修复重建外科杂志, 2011, 25(4):510-512.
3. 冯明录, 何勇, 董涛, 等. 拇指软组织缺损显微修复治疗方法分析. 中华显微外科杂志, 2010, 33(6):517-518.
4. 侍朋举, 张文龙, 赵刚, 等. 足背皮瓣串并联甲复合组织瓣修复手部脱套伤伴拇指缺损. 中国修复重建外科杂志, 2015, 29(7):799-803.
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. 仇申强, 王增涛, 孙文海, 等. 手指再造术中甲瓣供区的修复. 中华显微外科杂志, 2011, 34(4):272-275.
7. 王保山, 郑晓菊, 王新宏, 等. 甲瓣切取术后创面的处理. 中华显微外科杂志, 2009, 32(1):26-28.
8. 程鹏, 郑元波, 李丽. 四肢组织移植后供区继发损伤的处理方法探讨. 浙江创伤外科, 2011, 16(1):65-67.
9. 侯春林. 供求同重-提高我国组织移植修复缺损及功能重建水平. 中国修复重建外科杂志, 2005, 19(7):499-500.
10. 康庆林, 柴益民, 曾炳芳, 等. 甲瓣切取术后供区创面覆盖的方法选择. 中华显微外科杂志, 2007, 30(4):267-269.
11. 夏晓丹, 谢松林, 黄雄杰, 等. 股前外侧穿支皮瓣修复甲瓣再造拇指足供区皮肤缺损. 中国修复重建外科杂志, 2014, 28(1):127-128.
12. 姜晓华, 马合龙. 足拇甲瓣治疗单手指脱套伤并跗外侧皮瓣修复足供区. 中国美容医学, 2012, 21(7)下:60-61.
13. 李宗军, 肖春凌, 殷建新, 等. 腓动脉终末穿支蒂腓浅神经营养血管岛状皮瓣修复前足供区创面. 中国修复重建外科杂志, 2009, 23(2):209-211.
14. 郑艳峰, 沈晓霞, 朱家骏, 等. 腓浅神经营养血管皮瓣修复足部供区创面的临床应用. 中华显微外科杂志, 2013, 36(6):572-573.
15. 魏勇, 李钧, 童哲, 等. 跗外侧皮瓣修复甲皮瓣术中趾供区的创面. 中华手外科杂志, 2010, 26(5):318.
16. 杨庆达, 张智钊, 卢家灵, 等. 改良第一趾蹼皮瓣游离移植术后供区创面的修复. 中国修复重建外科杂志, 2013, 27(10):1279-1280.
17. 徐达传, 张世民, 唐茂林. 穿支皮瓣及相关术语的初步共识. 中华显微外科杂志, 2011, 34(5):358-359.
18. 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.
19. Kimura N, Satoh K, Hosaka Y. Tensor fasciae latae perforator flap. Clin Plast Surg, 2003, 30(3):439-446.

Chinese Journal of Reparative and Reconstructive Surgery

FREE CROIN FLAP FOR REPAIRING DEFECTS OF DONOR AFTER TOE TISSUE TRANS PLANTATION

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