Akdag Osman, Karamese Mehtap, NebilSelimoglu Muhammed, Akatekin Ahmet, Abacı Malik, Sutcu Mustafa, Tosun Zekeriya
Department of Plastic Reconstructive and Aesthetic Surgery, Selcuk University, Konya, Turkey.
Department of Plastic Reconstructive and Aesthetic Surgery, Medipol University, Istanbul, Turkey.
Eplasty. 2016 Dec 23;16:e35. eCollection 2016.
The reverse radial forearm flap has been used for soft-tissue hand defect surgical procedures worldwide. One of the major drawbacks of this flap, however, is donor site morbidity, as the donor site is closed with a skin graft. Problems with skin graft donor areas include adhesion, contracture, and wound-healing complications. In this study, only the adipofascial component of a reverse radial forearm flap was used to prevent these problems; in addition, a skin graft was applied over the flap instead of over the donor site. Between January 2011 and December 2013, a total of 13 hand defects were reconstructed with a reverse adipofascial radial forearm flap. Patients were evaluated for functional results using total active motion criteria and disability of the arm, shoulder, and hand scores, operation time, hospitalization time, and patient satisfaction. All flaps and grafts placed on flaps survived completely and donor sites healed without complications. The total active motion criteria and the disability of the arm, shoulder, and hand score demonstrated that the functional outcomes were successful. Patient satisfaction scores using the visual analog scale had a mean of 88.3 (SD = 2.95) mm. Operation time for the flap surgery was 126.1 (SD = 21.80) minutes, and patients were discharged at an average of 6.3 (SD = 1.44) days. Use of an adipofascial component in reverse radial forearm flap surgery is appropriate for reducing problems with donor site skin grafts. Patients' functional outcomes denoted that the reverse adipofascial radial forearm flap is a reliable and effective method to cover soft-tissue defects of the hand. .
桡侧前臂逆行皮瓣已在全球范围内用于手部软组织缺损的外科手术。然而，该皮瓣的主要缺点之一是供区并发症，因为供区需用皮肤移植来闭合。皮肤移植供区的问题包括粘连、挛缩和伤口愈合并发症。在本研究中，仅使用桡侧前臂逆行皮瓣的脂肪筋膜成分来预防这些问题；此外，将皮肤移植应用于皮瓣上而非供区。在2011年1月至2013年12月期间，共有13例手部缺损采用桡侧前臂逆行脂肪筋膜皮瓣进行重建。使用总主动活动标准、手臂、肩部和手部残疾评分、手术时间、住院时间和患者满意度对患者的功能结果进行评估。所有皮瓣及置于皮瓣上的移植组织均完全存活，供区愈合无并发症。总主动活动标准以及手臂、肩部和手部残疾评分表明功能结果是成功的。采用视觉模拟量表的患者满意度评分平均为88.3（标准差 = 2.95）mm。皮瓣手术的手术时间为126.1（标准差 = 21.80）分钟，患者平均在6.3（标准差 = 1.44）天出院。在桡侧前臂逆行皮瓣手术中使用脂肪筋膜成分适用于减少供区皮肤移植的问题。患者的功能结果表明，桡侧前臂逆行脂肪筋膜皮瓣是覆盖手部软组织缺损的一种可靠且有效的方法。
