The free neurovascular transverse wrist crease flap for repairing soft tissue defects of the fingers: clinical outcomes of multiple centers

Fan, Zhiqiang; Yu, Bao‐Fu; Zeng, Qi; Cai, Bo; Xia, Guoming; Huang, S. Joseph

doi:10.1186/s13018-019-1444-y

Cited by 8 publications

(5 citation statements)

References 26 publications

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“…The average ROM of DIP, PIP, and MP were 35°, 82°, and 85°, respectively, in the affected finger, all of which are satisfactory for reconstructed fingers. The hand function and patient self-evaluations are consistent with previous studies using other free flaps (i.e., superficial palmar branches of the radial artery free flap) for reconstructing digital defects [ 23 ].…”

Section: Discussionsupporting

confidence: 85%

The free flap based on a single proximal perforator of the radial artery: ultrasonography study and clinical applications in reconstruction of soft tissue defects in finger

Zhang

et al. 2022

Eur J Med Res

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Objectives To locate an anastomosable constant perforator of the radial artery on the proximal forearm using ultrasonography and describe the application of a free radial artery flap based on a single proximal perforator for the reconstruction of soft tissue defects in finger. Methods In 20 forearms (ten right and ten left) from ten volunteers, the perforators in the proximal half of the forearm from the radial artery were visualized using ultrasonography. The free radial artery perforator flaps based on the single perforator were used to reconstruct digital soft tissue defects in four cases between October 2017 and May 2018. Results Of the 20 forearms, an anastomosable perforator was consistently detected in the radial artery in the forearm’s proximal half. The perforator diameter was 0.7 ± 0.1 mm, and the pedicle length was 12 ± 3 mm according to ultrasonography. The perforator’s location was far from the elbow crease (8.8 ± 1.4 cm), and the relative distance of the perforator’s location from the elbow crease to the wrist crease was 37.2% ± 4.8%. In clinical cases, all flaps survived. Flap size ranged from 3.5 to 6.5 cm in length and 2.3–3.0 cm in width. Donor sites of the forearm were closed primarily in all cases. During a mean period of 12 months (8–14 months) follow-up, the average static 2-PD was 13.8 mm (10–18 mm) in the flap area, and the ROM of DIP was 35° (30–40°), PIP was 82° (45–110°), and MP was 85° (70–90°) of the affected finger. The mean Brief Michigan Hand Questionnaire (BMHQ) score was 72.9 (60.4–85.4) in the affected hand. Conclusions An anastomosable perforator is consistently located on the radial artery in the proximal half of the forearm. The free radial artery flap based on this single perforator provides acceptable functional and cosmetic outcomes for reconstructing digital soft tissue defects. With the preservation of the forearm’s main vessel (radial artery), this flap provides another reliable option for hand surgeons to reconstruct small soft tissue defects in finger.

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Section: Discussionsupporting

confidence: 85%

The free flap based on a single proximal perforator of the radial artery: ultrasonography study and clinical applications in reconstruction of soft tissue defects in finger

Zhang

et al. 2022

Eur J Med Res

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“…Hypothenar free flap, venous flap, temporoparietal fascial flap, lateral arm flap, free posterior interosseous flap, toe plantar flap, and innervated radial artery superficial palmar branch flap does the same for fingertip, volar, or degloving defects 5–10 . Although free flaps are technically more demanding, they offer a favorable cosmetic result and acceptable donor site morbidity 25–34 …”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10] Although free flaps are technically more demanding, they offer a favorable cosmetic result and acceptable donor site morbidity. [25][26][27][28][29][30][31][32][33][34] The ALT perforator flap is an excellent material for the development of reconstructing different parts of the body. The ALT has a long-standing heritage as a workhorse-free flap.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Finger Soft Tissue Defects With a Thinned Free Anterolateral Thigh Flap

et al. 2023

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Background Reconstructing complex soft tissue defects of the finger requires both functional and aesthetic aspects. There are many free tissue transfers as suitable options for digital resurfacing. The anterolateral thigh (ALT) flap is not the first choice for reconstruction of this area because it has the disadvantage that the subcutaneous tissue is too thick; however, its use as a thinned form has yet to be described much. This study presents the flap thinning technique in the small-sized ALT flap for the finger soft tissue defect. Method From May 2009 to March 2018, 10 patients with complete circumferential or semicircumcision defects in the fingers underwent reconstructive procedures that included thinned ALT flap transfer. Finger soft tissue damage due to contusion trauma includes loss of skin and exposure of the bone and tendon. The flap is thinned in 2 different ways: peripheral thinning and total microsurgical thinning, which is selected based on the perforator vessel structure of the flap. Result The ALT flap sizes, averaging 4–9 cm wide and 6–12 cm long, were thinned to 4–7 mm. One perforator was included in the flaps with a pedicle length average of 6.1 cm. The flaps survived entirely in all patients except one with a 30% area in the distal part of the thinned ALT flap that became necrotic because of venous occlusion. Donor sites were closed primarily for all patients. No patients required secondary flap defatting. Conclusions The small thinned ALT perforator flap can be an excellent option for full circumferential or semicircumferential soft tissue defects of the finger. Follow-up showed this as an excellent alternative for finger reconstruction in terms of aesthetic appearance and functional outcome.

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“…12 Different parts of the wound have different properties, so skin flaps consistent with the wound can be selected for repair, which has a significant impact on the appearance of the wound, hand function and daily life of the patient. 13 Quan Wang et al When it comes to refractory wounds, a variety of repair methods can be applied. 14 With flap therapy, important tissues in the deep part of the wound can be covered and effectively treated, so that the ideal therapeutic effect can be realized on the appearance of the injured wound and the function of the limb.…”

Section: Discussionmentioning

confidence: 99%

Clinical study on vacuum assisted closure combined with multiple flaps in the treatment of severe hand trauma

Wang

Zhang²,

Sun³

et al. 2021

Pak J Med Sci

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Objectives: To investigate the effect and clinical value of the application of vacuum assisted closure (VAC) combined with multiple flaps in the treatment of severe hand trauma. Methods: A total of 100 patients with severe hand trauma admitted to Harrison International Peace Hospital from September 2015 to September 2020 were selected and randomly divided into two groups according to the randomized block method: the single flap repair group and the combined repair group, with 50 patients in each group. Patients in the single flap repair group underwent flap repair according to their condition, while those in the combined repair group were treated with VAC prior to flap repair. The range of motion and hand sensation scores were compared between the two groups, and their levels of interleukin-8 (IL-8), tumor necrosis factor (TNF) and lipopolysaccharide (LPS) were tested by enzyme-linked immunosorbent assay (ELIS). Moreover, the flap survival rate and the incidence of adverse events were recorded and compared between the two groups. Results: Compared with the single flap repair group, the combined repair group had higher range of motion and hand sensation score (p<0.05), lower levels of IL-8, TNF and LPS (p<0.05), higher flap survival rate (p<0.05), and lower incidence of adverse events (p<0.05). Conclusion: VAC combined with multiple flaps boasts significant trauma repair effect and preferable clinical application value in the treatment of patients with severe hand trauma, which is principally reflected in significantly improving the hand function of patients and remarkably alleviating the inflammatory response of patients. doi: https://doi.org/10.12669/pjms.38.1.4631 How to cite this:Wang Q, Zhang X, Sun W, Li H. Clinical study on vacuum assisted closure combined with multiple flaps in the treatment of severe hand trauma. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4631 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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The free neurovascular transverse wrist crease flap for repairing soft tissue defects of the fingers: clinical outcomes of multiple centers

Cited by 8 publications

References 26 publications

The free flap based on a single proximal perforator of the radial artery: ultrasonography study and clinical applications in reconstruction of soft tissue defects in finger

The free flap based on a single proximal perforator of the radial artery: ultrasonography study and clinical applications in reconstruction of soft tissue defects in finger

Reconstruction of Finger Soft Tissue Defects With a Thinned Free Anterolateral Thigh Flap

Clinical study on vacuum assisted closure combined with multiple flaps in the treatment of severe hand trauma

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