Free superficial circumflex iliac artery flap combined with deep inferior epigastric perforator flap for repair of large soft tissue defects of upper extremities_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

OU Changliang ¹ ^# , LUO Xuchao ¹ ^# , ZHOU Xin ² ,  ZOU Yonggen ¹ ^# , LI Jiayu , YANG Yingqiu

Department of Orthopedics, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou Sichuan, 646000, P. R. China;

Corresponding author：

ZOU Yonggen, Email: 452036229@qq.com

Keywords：

Superficial circumflex iliac artery flap; deep inferior epigastric perforator flap; soft tissue defect; upper extremity

DOI：

10.7507/1002-1892.202204071

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of free superficial circumflex iliac artery flap (SCIP) combined with deep inferior epigastric perforator flap (DIEP) in repairing large soft tissue defects of upper extremities. Methods Between February 2017 and January 2021, free SCIP combined with DIEP was used to repair 15 patients with large soft tissue defects of upper extremities. There were 12 males and 3 females, aged from 34 to 52 years, with a median age of 41 years. The causes of injury were mechanical injury in 11 cases and traffic accident injury in 4 cases. There were 9 cases of circular skin defect in the forearm and 6 cases of skin defect around the upper arm and elbow joint, with the defect in size of 15.5 cm×10.5 cm to 26.5 cm×15.5 cm, accompanied by exposure of deep tissues such as tendons and bones. There were 7 cases with open fractures and 8 cases with vascular and nerve injuries. The time from injury to operation ranged from 7 to 14 days, with an average of 7.5 days. The flaps in size of 16.0 cm×11.0 cm to 27.0 cm×16.0 cm were harvested; the thickness of the flaps was 0.8-1.3 cm, and the excess fat tissue was removed under the microscope after harvesting. The length of proximal vascular pedicle was 5.0-7.0 cm, and of distal vascular pedicle was 3.0-5.0 cm. The donor site was closed and sutured directly, and the navel was reconstructed. Results The flaps survived successfully in 14 cases, and the arterial crisis occurred in 1 case at 10 hours after operation, and the flap survived after surgical exploration. All the wounds in the donor and recipient sites healed by first intention. All 15 patients were followed up 3-14 months, with an average of 10.5 months. The appearance, elasticity, and texture of flap were good without obvious bloat, contracture, or adhesion. The donor site healed well, no abdominal wall hernia was found, and the appearance of reconstructed navel was good, only linear scar left. At last follow-up, 12 cases were evaluated as excellent and 3 cases were good according to the evaluation criteria of flap function of the Chinese Medical Association Microsurgery Branch. The sensation recovered to in 7 cases and in 8 cases. Conclusion Free SCIP combined with DIEP has a large excision area and excellent skin ductility. It is an effective clinical method for repairing large soft tissue defects of upper extremities.

Citation： OU Changliang, LUO Xuchao, ZHOU Xin, ZOU Yonggen, LI Jiayu, YANG Yingqiu. Free superficial circumflex iliac artery flap combined with deep inferior epigastric perforator flap for repair of large soft tissue defects of upper extremities. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(9): 1150-1154. doi: 10.7507/1002-1892.202204071 Copy

1.	刘安铭, 周鑫, 欧昌良, 等. 携带双侧旋髂浅动脉的腹部游离皮瓣修复足踝部大面积皮肤软组织缺损. 中国修复重建外科杂志, 2021, 35(7): 886-890.
2.	戚建武, 陈邵, 陈川, 等. 游离旋髂浅动脉皮瓣联合股前外侧皮瓣修复手部大面积皮肤缺损的疗效. 中华创伤杂志, 2021, 37(9): 805-810.
3.	刘胜哲, 巨积辉, 柳志锦, 等. 串并联双股前外侧超长穿支皮瓣修复四肢大面积创面的临床效果. 中华烧伤杂志, 2021, 37(3): 250-256.
4.	周鑫, 宋达疆, 邹永根. 游离胸背动脉穿支皮瓣联合旋髂浅动脉穿支皮瓣移植修复下肢大面积环周软组织缺损一例. 中国修复重建外科杂志, 2021, 35(3): 399-400.
5.	利春叶, 王建云, 廖全全, 等. 不同张力缝合对皮瓣愈合影响的实验研究. 中华显微外科杂志, 2006, 29(4): 284-286.
6.	胡智玉, 宋力, 周明武, 等. 串联组合式穿支嵌合组织瓣修复重建足踝部复合组织缺损六例. 中华显微外科杂志, 2021, 44(1): 68-71.
7.	孙广峰, 邓呈亮, 吴必华, 等. 修薄股前外侧穿支分叶皮瓣修复手部创面. 中华手外科杂志, 2018, 34(2): 81-83.
8.	高登文, 王耀军, 任忠亮, 等. 足底内侧岛状皮瓣联合腹股沟游离皮瓣修复足跟部软组织缺损. 中华整形外科杂志, 2022, 38(1): 5-9.
9.	Koshima I, Yamamoto T, Narushima M, et al. Perforator flaps and supermicrosurgery. Clin Plast Surg, 2010, 37(4): 683-689.
10.	Sinna R, Hajji H, Qassemyar Q, et al. Anatomical background of the perforator flap based on the deep branch of the superficial circumflex iliac artery (SCIP flap): A cadaveric study. Eplasty, 2010, 10: e11.
11.	Taylor GI, Corlett RJ, Boyd JB. The versatile deep inferior epigastric (inferior rectus abdominis) flap. Br J Plast Surg, 1984, 37(3): 330-350.
12.	Munhoz AM, Ishida LH, Sturtz GP, et al. Importance of lateral row perforator vessels in deep inferior epigastric perforator flap harvesting. Plast Reconstr Surg, 2004, 113(2): 517-524.
13.	Mangelsdorff G, Cuevas P, Rodriguez JR, et al. Reduced anterolateral thigh flap donor-site morbidity using incisional negative pressure therapy. J Reconstr Microsurg, 2019, 35(3): 229-234.
14.	Nikkhah D, Miller R, Pafitanis G, et al. Five simple techniques to enable rapid elevation and donor site closure of the anterolateral thigh flap. J Hand Microsurg, 2019, 11(1): 54-56.
15.	Kita Y, Fukunaga Y, Arikawa M, et al. Anatomy of the arterial and venous systems of the superficial inferior epigastric artery flap: A retrospective study based on computed tomographic angiography. J Plast Reconstr Aesthet Surg, 2020, 73(5): 870-875.

1. 刘安铭, 周鑫, 欧昌良, 等. 携带双侧旋髂浅动脉的腹部游离皮瓣修复足踝部大面积皮肤软组织缺损. 中国修复重建外科杂志, 2021, 35(7): 886-890.
2. 戚建武, 陈邵, 陈川, 等. 游离旋髂浅动脉皮瓣联合股前外侧皮瓣修复手部大面积皮肤缺损的疗效. 中华创伤杂志, 2021, 37(9): 805-810.
3. 刘胜哲, 巨积辉, 柳志锦, 等. 串并联双股前外侧超长穿支皮瓣修复四肢大面积创面的临床效果. 中华烧伤杂志, 2021, 37(3): 250-256.
4. 周鑫, 宋达疆, 邹永根. 游离胸背动脉穿支皮瓣联合旋髂浅动脉穿支皮瓣移植修复下肢大面积环周软组织缺损一例. 中国修复重建外科杂志, 2021, 35(3): 399-400.
5. 利春叶, 王建云, 廖全全, 等. 不同张力缝合对皮瓣愈合影响的实验研究. 中华显微外科杂志, 2006, 29(4): 284-286.
6. 胡智玉, 宋力, 周明武, 等. 串联组合式穿支嵌合组织瓣修复重建足踝部复合组织缺损六例. 中华显微外科杂志, 2021, 44(1): 68-71.
7. 孙广峰, 邓呈亮, 吴必华, 等. 修薄股前外侧穿支分叶皮瓣修复手部创面. 中华手外科杂志, 2018, 34(2): 81-83.
8. 高登文, 王耀军, 任忠亮, 等. 足底内侧岛状皮瓣联合腹股沟游离皮瓣修复足跟部软组织缺损. 中华整形外科杂志, 2022, 38(1): 5-9.
9. Koshima I, Yamamoto T, Narushima M, et al. Perforator flaps and supermicrosurgery. Clin Plast Surg, 2010, 37(4): 683-689.
10. Sinna R, Hajji H, Qassemyar Q, et al. Anatomical background of the perforator flap based on the deep branch of the superficial circumflex iliac artery (SCIP flap): A cadaveric study. Eplasty, 2010, 10: e11.
11. Taylor GI, Corlett RJ, Boyd JB. The versatile deep inferior epigastric (inferior rectus abdominis) flap. Br J Plast Surg, 1984, 37(3): 330-350.
12. Munhoz AM, Ishida LH, Sturtz GP, et al. Importance of lateral row perforator vessels in deep inferior epigastric perforator flap harvesting. Plast Reconstr Surg, 2004, 113(2): 517-524.
13. Mangelsdorff G, Cuevas P, Rodriguez JR, et al. Reduced anterolateral thigh flap donor-site morbidity using incisional negative pressure therapy. J Reconstr Microsurg, 2019, 35(3): 229-234.
14. Nikkhah D, Miller R, Pafitanis G, et al. Five simple techniques to enable rapid elevation and donor site closure of the anterolateral thigh flap. J Hand Microsurg, 2019, 11(1): 54-56.
15. Kita Y, Fukunaga Y, Arikawa M, et al. Anatomy of the arterial and venous systems of the superficial inferior epigastric artery flap: A retrospective study based on computed tomographic angiography. J Plast Reconstr Aesthet Surg, 2020, 73(5): 870-875.

Chinese Journal of Reparative and Reconstructive Surgery

Free superficial circumflex iliac artery flap combined with deep inferior epigastric perforator flap for repair of large soft tissue defects of upper extremities

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content