To meet the special need of function and cosmetics, thin skin flap was used in repair of skin defect of hand. It was reported that 37 cases with skin defect of hand had been treated since 1992. Eight kinds of flaps were used, including sub-abdominal flap (in 8 cases), paraumbilical flap (in 8 cases), intercostal flap (in 5 cases), subclavicular flap (in 3 cases), thoracoacromial flap (in 3 cases), trigonum clavopectoral flap (in 4 cases), thenal flap (in 2 cases) and pedicled flap carrying superficial iliac circumflex artery (in 4 cases). All of defects were treated by one-stage operation. The size of the flaps used ranged from the minimum of 1.2 cm x 2.5 cm to the maximum of 10 cm x 16 cm. All the flaps were survived. The function and appearance of the hands were satisfactory. It was noted that thin skin flap had developed from conventional pedicled flap and subcorium vascular-net flap, but it was easy to perform and had a high rate of success. The principle in choosing the flap was also discussed. It was suggested that more attention should be concentrated to solve the problems encountered in the use of thin skin flap in the repair of skin defect.
Objective To establish a new operative method to repair defects of palm and proximal fingers with double vascular pedicle flaps. Methods From August 1992 to June 2000, 20 cases of soft tissue defects of palm and fingers were repaired with double vascular pedicle flaps. Twenty patients included 9 males and 11 females, aged 17-35 years. The causes were crush,avulsion, and so on. The interval between injury and operation was 3-11 hours.The wound area ranged from 8 cm×12 cm to 10 cm×20 cm. We devised the two side flaps on pectoral-umbilical place with well-known blood vessel to cover flexion and extension regions of palm and the multi-lobes skin flap to cover defect of fingers simultaneously. Results Out of 20 patients, 19 were followed up 8-12 months with an average of 9.8 months. All the flaps survived completely. The skin colour and the contour of the palm and digits were good. Conclusion The double vascular pedicle flap is one of the best choices torepair soft tissue defect of the palm and proximal fingers; the procedure is simple and the operation is extended easily.