Cheema Saeed Ashraf, Talaat Nabeela
Department of Plastic Surgery, Services Institute of Medical Sciences and Services Hospital, Lahore, Pakistan.
J Ayub Med Coll Abbottabad. 2009 Jan-Mar;21(1):35-8.
To highlight the usefulness of reverse radial artery flap in covering various soft tissue defects of hand in paediatric age group.
A total of 16 reverse radial artery flaps were utilized in a period of three years to cover various soft tissue defects of hand for paediatric age group patients. The age ranged from 5-18 years. The two common causes of soft tissue defects in this series were mechanical trauma and fireworks trauma with five cases in each group. Three of the cases were burn victims and other two presented with earth quake injuries. One patient had wound because of road traffic accident. Soft tissue defects of palm were covered with this flap in eight cases while in three cases it was wrapped around the thumb. First web space defects were covered with this flap in two cases. Two cases required coverage of amputation stump at transmetacarpal level and yet another required a big flap to cover the soft tissue defects at palm, dorsum and thumb. Donor site was covered with split skin graft in all cases but one, which was closed primarily.
We had partial loss of flap in one case. Grafted donor sites healed uneventfully and were quite acceptable to the patients in due course of time.
Reverse radial artery flap has a quite long arc of rotation which brings it great ease to cover the soft tissue defects of various areas of hand like palm, dorsum, first web space and thumb.
强调逆行桡动脉皮瓣在覆盖小儿手部各种软组织缺损方面的实用性。
在三年时间里共使用16例逆行桡动脉皮瓣,为小儿患者覆盖手部各种软组织缺损。年龄范围为5至18岁。本系列中软组织缺损的两个常见原因是机械创伤和烟花创伤,每组各5例。其中3例为烧伤患者,另外2例为地震伤。1例患者因道路交通事故受伤。8例手掌软组织缺损用此皮瓣覆盖,3例包裹拇指。2例第一掌骨间隙缺损用此皮瓣覆盖。2例需要覆盖掌骨水平的截肢残端,另有1例需要大皮瓣覆盖手掌、手背和拇指的软组织缺损。除1例直接缝合外,所有供区均用中厚皮片覆盖。
1例皮瓣部分坏死。移植的供区愈合良好,患者在一段时间后对此相当满意。
逆行桡动脉皮瓣旋转弧较长,能很容易地覆盖手部不同区域如手掌、手背、第一掌骨间隙和拇指的软组织缺损。