Hu Haoliang, Chen Hong, Hong Jinjiong, Mao Weisheng, Tian Mintao, Wang Liping, Dong Jianghui, Li Xueyuan
Department of Hand Surgery, Ningbo No. 6 Hospital, Ningbo, 315040, China.
School of Pharmacy and Medical Sciences, and UniSA Cancer Research Institute, University of South Australia, Adelaide, SA, 5001, Australia.
BMC Surg. 2019 Dec 11;19(1):188. doi: 10.1186/s12893-019-0649-7.
When restoring the appearance and function of the fingers, hand surgeons face a challenge in choosing a suitable surgical method to repair finger skin defects.
In this study, we designed a long elliptical flap based on a propeller perforator flap and located slightly toward the dorsal lateral aspect of the finger. The flap with a pedicle consisting of the dorsal perforator of the distal digital artery and dorsal digital artery perforator chain is rotated to cover a large wound on the distal end. From December 2014 to December 2017, 10 patients with finger soft tissue defects were treated with the propeller perforator flap described in this study.
All flaps survived after surgery, and 2 had a transient venous congestion. After a follow-up period of 3 to 12 months, the static two-point discrimination of the flap was 8.06 ± 1.75 mm, and the range of motion was 149.4 ± 12.9°. This designed flap can span several angiosomes supplied by the perforators. Due to the inclusion of a vessel chain between the dorsal digital artery perforators, the length-to-width ratio of the flap can be up to 3:1.
This technique increases the size of flap that can be harvested safely while retaining a reliable blood supply. The present study describes a new method for repairing soft tissue defects of the finger by using the technique of propeller perforator flaps based on dorsal digital artery perforator chains.
The registration number of this study is ChiCTR1800014588; it has been retrospectively registered with Chinese Clinical Trial Registry (chictr.org.cn), 18/11/2019.
在恢复手指外观及功能时，手外科医生在选择合适的手术方法修复手指皮肤缺损方面面临挑战。
在本研究中，我们设计了一种基于螺旋桨穿支皮瓣且略朝向手指背外侧的长椭圆形皮瓣。该皮瓣以指动脉远侧穿支和指背动脉穿支链组成的蒂进行旋转，以覆盖远端的大创面。2014年12月至2017年12月，10例手指软组织缺损患者接受了本研究中描述的螺旋桨穿支皮瓣治疗。
术后所有皮瓣均存活，2例出现短暂性静脉淤血。随访3至12个月，皮瓣静态两点辨别觉为8.06±1.75mm，活动度为149.4±12.9°。这种设计的皮瓣可跨越由穿支供血的多个血管体。由于指背动脉穿支之间包含血管链，皮瓣长宽比可达3:1。
该技术在保留可靠血供的同时，增加了可安全切取的皮瓣面积。本研究描述了一种基于指背动脉穿支链的螺旋桨穿支皮瓣技术修复手指软组织缺损的新方法。
本研究注册号为ChiCTR1800014588；于2019年11月18日在中文临床试验注册中心（chictr.org.cn）进行回顾性注册。
