Xu Xiang, Wang Cheng, Chen Zhenbing, Li Jin
Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Surg. 2022 Jul 26;9:934173. doi: 10.3389/fsurg.2022.934173. eCollection 2022.
Soft tissue defects of fingers are common in reconstructive plastic surgery, and reconstruction of the defects remains challenging for plastic surgeons. In our study, we reported our experience in finger reconstruction with a medial plantar artery perforator (MPAP) flap, especially using a lobulated MPAP flap for the complex multifinger soft defect.
From the period April 2012 to October 2018, 11 patients (9 males and 2 females) with an average age of 44 years old (ranging from 11 to 58) received finger reconstruction with a free MPAP flap. In total, 11 flaps (8 single-lobulated flaps and 3 two-lobulated flaps) were raised from the ipsilateral or contralateral instep area. Trauma and scar contracture caused hand soft tissue loss in all cases.
The sizes of the flaps ranged from 2×3 to 5×7.5 cm. All flaps survived intact with no complications. One donor site was closed primarily, and other donor sites were covered with a full-thickness skin graft. The mean follow-up time was 6 months (ranging from 3 to 8 months). During the follow-up period, the patients were satisfied with their appearance without any traces of flap plastic surgery.
The MPAP flap is a reliable and acceptable option for the reconstruction of complex soft tissue defects in the finger. Depending on the two branches of the medial plantar artery, the use of the lobulated MPAP flap holds promise in the treatment of multifinger soft tissue defects.
手指软组织缺损在整形重建外科中很常见，缺损的重建对整形外科医生来说仍然具有挑战性。在我们的研究中，我们报告了使用足底内侧动脉穿支（MPAP）皮瓣进行手指重建的经验，特别是使用分叶状MPAP皮瓣修复复杂的多指软组织缺损。
2012年4月至2018年10月期间，11例患者（9例男性，2例女性）平均年龄44岁（11至58岁）接受了游离MPAP皮瓣手指重建。总共从同侧或对侧足背区域切取了11个皮瓣（8个单叶皮瓣和3个双叶皮瓣）。所有病例均因外伤和瘢痕挛缩导致手部软组织缺损。
皮瓣大小为2×3至5×7.5 cm。所有皮瓣均完全存活，无并发症。1个供区直接缝合关闭，其他供区采用全厚皮片覆盖。平均随访时间为6个月（3至8个月）。随访期间，患者对外观满意，无皮瓣整形手术痕迹。
MPAP皮瓣是修复手指复杂软组织缺损的可靠且可接受的选择。根据足底内侧动脉的两个分支，分叶状MPAP皮瓣在治疗多指软组织缺损方面具有应用前景。
