Application of free superficial palmar branch of radial artery flap in repairing of soft tissue defect of fingers_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANG Liangku ¹ , XU Yuben ¹ , LI Peng ¹ , XIA Lei ¹ , TIAN Zhao ¹ , LU Meng ¹ ,  XU Tao ²

1. The Second Department of Hand Surgery, Red Cross Hospital Affiliated to Medical School of Xi’an Jiao Tong University, Xi’an Shaanxi, 710054, P.R.China;
2. Department of Anesthesia, Red Cross Hospital Affiliated to Medical School of Xi’an Jiao Tong University, Xi’an Shaanxi, 710054, P.R.China;

Corresponding author：

XU Tao, Email: xutao19850315@163.com

Keywords：

Superficial palmar branch of the radial artery; perforators flap; finger; soft tissue defect; wound repair

DOI：

10.7507/1002-1892.201801040

Video：

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ObjectiveTo evaluate the surgical technique and the effectiveness of the free superficial palmar branch of the radial artery flap to repair soft tissue defect of fingers.MethodsBetween June 2014 and June 2017, 10 cases (10 fingers) of soft tissue defects of fingers were repaired with the free superficial palmar branch of the radial artery flaps. There were 8 males and 2 females with an average age of 29.8 years (range, 23-42 years). The causes of injury included the chainsaw cutting injury in 6 cases, the machine crush injury in 2 cases, and the glass scratching in 2 cases. The time from injury to admission was 1-8 hours with an average of 3 hours. The locations were the volar of the middle of index finger in 3 cases, the volar of the distal of index finger in 1 case, the volar of the distal of middle finger in 3 cases, the ulnar side of distal interphalangeal joint of ring finger in 1 case, and the volar of the distal of the little finger in 2 cases. The area of soft tissue defect ranged from 1.8 cm×0.9 cm to 2.8 cm×2.1 cm, and the area of flap ranged from 2.0 cm×1.0 cm to 3.0 cm×2.3 cm. The donor sites were sutured directly.ResultsAll flaps survived after operation, and the wounds healed by first intention. The incisions of donor site also healed by first intention with a linear scar. All cases were followed up 6-12 months (mean, 9 months). The appearance and texture of the flaps were satisfactory. The pain sensation, warm sensation, and touch sensation of the flap recovered. At last follow-up, the two-point discrimination of the flap was 6-13 mm (mean, 7.5 mm). According to the assessment of the upper limb function issued by tha Hand Surgery Society of Chinese Medical Association, the results were graded as excellent in 8 cases and good in 2 cases.ConclusionThe free superficial palmar branch of the radial artery flap is easy to harvest and anastomose and has small injury. It is an ideal method in repairing of soft tissue defects of fingers.

Citation： HUANG Liangku, XU Yuben, LI Peng, XIA Lei, TIAN Zhao, LU Meng, XU Tao. Application of free superficial palmar branch of radial artery flap in repairing of soft tissue defect of fingers. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(7): 955-958. doi: 10.7507/1002-1892.201801040 Copy

1.	Chen C, Tang P, Zhang X. Sensory reconstruction of a finger pulp defect using a dorsal homodigital island flap. Plast Reconstr Surg, 2012, 130(5): 1077-1086.
2.	肖建林, 廖前德, 戴顺平, 等. 桡动脉掌浅支腕横纹皮瓣微创修复手部软组织缺损. 临床骨科杂志, 2016, 19(6): 713-715.
3.	尚修超, 张乃臣, 刘宏君, 等. 游离桡动脉掌浅支皮瓣修复手指软组织缺损. 中华手外科杂志, 2015, 31(1): 77.
4.	Kamei K, Ide Y, Kimura T. A new free thenar flap. Plast Reconstr Surg, 1993, 92(7): 1380-1384.
5.	Sakai S. Free flap from the flexor aspect of the wrist for resurfacing defects of the hand and fingers. Plast Reconstr Surg, 2003, 111(4): 1412-1420.
6.	郑大伟, 黎章灿, 曹广超, 等. 多种类型的桡动脉掌浅支腕横纹部游离皮瓣修复手指复合软组织缺损. 中华显微外科杂志, 2016, 39(1): 12-16.
7.	潘达德, 顾玉东, 侍德. 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.
8.	梁文勇, 曾文超, 纪林善, 等. 胫后动脉穿支皮瓣游离移植修复手部软组织缺损的临床效果. 中国医师杂志, 2016, 18(4): 616-618.
9.	Okochi M, Saito M, Ueda K. Simple and easy reconstruction of nail matrix lesion using lateral finger flap after excision of digital mucous cyst. Case Reports Plast Surg Hand Surg, 2016, 3(1): 16-19.
10.	芮永军, 张雁, 杨红, 等. 术前不同定位方法在股前外侧穿支皮瓣应用的对比分析. 中华显微外科杂志, 2015, 38(1): 33-37.
11.	莫勇军, 谭海涛, 杨克勤, 等. 3D 技术在足趾微型皮瓣移植修复拇和手指缺损的应用. 中华显微外科杂志, 2015, 38(1): 294-297.
12.	Zheng DW, Li ZC, Sun F, et al. Use of a distal ulnar artery perforator-based bilobed free flap for repairing complex digital defects. J Hand Surg (Am), 2014, 39(11): 2235-2242.
13.	程超, 李梓瑞, 刘海波, 等. 游离桡动脉掌浅支腕横纹皮瓣修复手指软组织半环形缺损. 实用手外科杂志, 2016, 30(1): 94-95.
14.	14 张敬良, 雷彦文, 宋君, 等. 手部组织缺损修复方法的个性化路径式选择. 中华显微外科杂志, 2013, 36(4): 343-347.
15.	白辉凯, 谢振军, 赵国红, 等. 应用游离尺动脉腕上皮支皮瓣修复手部小面积皮肤缺损. 中华手外科杂志, 2017, (2):153-154.
16.	尚修超, 张乃臣, 刘宏君, 等. 游离桡动脉掌浅支皮瓣修复手指软组织缺损. 中华手外科杂志, 2015, 31(1): 77.
17.	强力, 薛明宇, 卜凡玉, 等. 游离腕横纹嵌合皮瓣修复手指复合组织缺损八例. 中华显微外科杂志, 2017, 40(4): 371-373.
18.	Omokawa S, Ryu J, Tang JB, et al. Vascular and neural anatomy of the thenar area of the hand: its surgical applications. Plast Reconstr Surg, 1997, 99(1): 116-121.
19.	张亚斌, 李会晓, 夏利锋, 等. 桡动脉腕横纹穿支皮瓣的解剖及临床应用. 中华显微外科杂志, 2015, 38(5): 479-481.
20.	Yang IW, Kim JS, Lee DC, et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. J Reconstr Microsurg, 2010, 26(8): 529-538.
21.	Simsek T, Engin MS, Aslan O, et al. Finger pulp reconstruction with free dorsoulnar perforator (DUAP) flap. J Reconstr Microsurg, 2011, 27(9): 543-549.

1. Chen C, Tang P, Zhang X. Sensory reconstruction of a finger pulp defect using a dorsal homodigital island flap. Plast Reconstr Surg, 2012, 130(5): 1077-1086.
2. 肖建林, 廖前德, 戴顺平, 等. 桡动脉掌浅支腕横纹皮瓣微创修复手部软组织缺损. 临床骨科杂志, 2016, 19(6): 713-715.
3. 尚修超, 张乃臣, 刘宏君, 等. 游离桡动脉掌浅支皮瓣修复手指软组织缺损. 中华手外科杂志, 2015, 31(1): 77.
4. Kamei K, Ide Y, Kimura T. A new free thenar flap. Plast Reconstr Surg, 1993, 92(7): 1380-1384.
5. Sakai S. Free flap from the flexor aspect of the wrist for resurfacing defects of the hand and fingers. Plast Reconstr Surg, 2003, 111(4): 1412-1420.
6. 郑大伟, 黎章灿, 曹广超, 等. 多种类型的桡动脉掌浅支腕横纹部游离皮瓣修复手指复合软组织缺损. 中华显微外科杂志, 2016, 39(1): 12-16.
7. 潘达德, 顾玉东, 侍德. 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.
8. 梁文勇, 曾文超, 纪林善, 等. 胫后动脉穿支皮瓣游离移植修复手部软组织缺损的临床效果. 中国医师杂志, 2016, 18(4): 616-618.
9. Okochi M, Saito M, Ueda K. Simple and easy reconstruction of nail matrix lesion using lateral finger flap after excision of digital mucous cyst. Case Reports Plast Surg Hand Surg, 2016, 3(1): 16-19.
10. 芮永军, 张雁, 杨红, 等. 术前不同定位方法在股前外侧穿支皮瓣应用的对比分析. 中华显微外科杂志, 2015, 38(1): 33-37.
11. 莫勇军, 谭海涛, 杨克勤, 等. 3D 技术在足趾微型皮瓣移植修复拇和手指缺损的应用. 中华显微外科杂志, 2015, 38(1): 294-297.
12. Zheng DW, Li ZC, Sun F, et al. Use of a distal ulnar artery perforator-based bilobed free flap for repairing complex digital defects. J Hand Surg (Am), 2014, 39(11): 2235-2242.
13. 程超, 李梓瑞, 刘海波, 等. 游离桡动脉掌浅支腕横纹皮瓣修复手指软组织半环形缺损. 实用手外科杂志, 2016, 30(1): 94-95.
14. 14 张敬良, 雷彦文, 宋君, 等. 手部组织缺损修复方法的个性化路径式选择. 中华显微外科杂志, 2013, 36(4): 343-347.
15. 白辉凯, 谢振军, 赵国红, 等. 应用游离尺动脉腕上皮支皮瓣修复手部小面积皮肤缺损. 中华手外科杂志, 2017, (2):153-154.
16. 尚修超, 张乃臣, 刘宏君, 等. 游离桡动脉掌浅支皮瓣修复手指软组织缺损. 中华手外科杂志, 2015, 31(1): 77.
17. 强力, 薛明宇, 卜凡玉, 等. 游离腕横纹嵌合皮瓣修复手指复合组织缺损八例. 中华显微外科杂志, 2017, 40(4): 371-373.
18. Omokawa S, Ryu J, Tang JB, et al. Vascular and neural anatomy of the thenar area of the hand: its surgical applications. Plast Reconstr Surg, 1997, 99(1): 116-121.
19. 张亚斌, 李会晓, 夏利锋, 等. 桡动脉腕横纹穿支皮瓣的解剖及临床应用. 中华显微外科杂志, 2015, 38(5): 479-481.
20. Yang IW, Kim JS, Lee DC, et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. J Reconstr Microsurg, 2010, 26(8): 529-538.
21. Simsek T, Engin MS, Aslan O, et al. Finger pulp reconstruction with free dorsoulnar perforator (DUAP) flap. J Reconstr Microsurg, 2011, 27(9): 543-549.

Chinese Journal of Reparative and Reconstructive Surgery

Application of free superficial palmar branch of radial artery flap in repairing of soft tissue defect of fingers

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