Lee Malrey, Lee Young-Keun, Kim Dong-Hee
The Research Center for Advanced Image and Information Technology, School of Electronics & Information Engineering, Chonbuk National University.
Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Chonbuk National University - Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Chonbuk, Republic of Korea.
Medicine (Baltimore). 2019 Jun;98(23):e16017. doi: 10.1097/MD.0000000000016017.
The purpose of this study is to report the clinical results of the arterialized venous free flaps in reconstructing soft tissue defects of the finger and to extend the indications for the use of the flaps based on clinical experiences of the authors.We retrospectively reviewed the records of 35 patients who underwent an arterialized venous free flaps for a finger reconstruction, between May 2007 and August 2015. The mean size of flap was 4.8 ± 1.23 × 3.1 ± 0.84 cm. The donor site was the ipsilateral volar aspect of the distal forearm in all cases. There were 17 (48.6%) cases of venous skin flaps, 9 (25.7%) cases of innervated venous flaps, 7 (20%) cases of tendocu taneous flaps, and 2 (5.7%) case of innervated tendocutaneous flap. The vascularity of recipient beds was good except 8 (22.9%) cases (partial devascularity in 3, more than 50% avascularity [bone cement] in 3, and chronic infected bed in 2).Of the 35 cases, 29 (82.9%) cases (including 3 cases who had more than 50% avascularity recipient bed) showed complete survival. 3 (8.6%) cases, which had partially devascularity of distal phalanx in recipient bed, showed partial necrosis (P = .015). The mean number of included veins was 2.4 ± 0.5 for a flap.A forearm arterialized venous free flap is a useful procedure for single-stage reconstructing of a soft tissue or combined defect of a finger, we consider that this technique could be applied to fingers despite an avascular or insufficient vascular recipient bed if the periphery of recipient bed vascularity was good and if the recipient beds were free from infection.
本研究旨在报告动脉化静脉游离皮瓣修复手指软组织缺损的临床结果，并根据作者的临床经验扩大皮瓣的应用指征。我们回顾性分析了2007年5月至2015年8月期间35例行动脉化静脉游离皮瓣修复手指的患者记录。皮瓣平均大小为4.8±1.23×3.1±0.84cm。所有病例供区均为同侧前臂远端掌侧。其中静脉皮瓣17例（48.6%），带神经静脉皮瓣9例（25.7%），肌腱皮瓣7例（20%），带神经肌腱皮瓣2例（5.7%）。除8例（22.9%）（3例部分血运障碍，3例超过50%无血运[骨水泥]，2例慢性感染创面）外，受区血运良好。35例中，29例（82.9%）（包括3例受区超过50%无血运的病例）皮瓣完全存活。3例（8.6%）受区远端指骨部分血运障碍，皮瓣部分坏死（P = 0.015）。每个皮瓣平均包含静脉数量为2.4±0.5条。前臂动脉化静脉游离皮瓣是一期修复手指软组织或复合缺损的有效方法，我们认为如果受区周边血运良好且无感染，即使受区血运缺失或不足，该技术也可应用于手指。
