Ou Chang Liang, Li Ji, Zhou Xin, Luo Xu Chao, Zou Yong Gen
Department of Orthopedic Hand Surgery, Guizhou Provincial People's Hospital, Guizhou, China.
Department of Spine & Tumor Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Injury. 2023 Mar;54(3):940-946. doi: 10.1016/j.injury.2023.01.016. Epub 2023 Jan 14.
Reconstruction and repair of multiple defects in the hand is a combination of function, sensation and aesthetics. The reconstruction using the superficial circumflex iliac artery perforator flap has become popular, which overcomes the inherent shortcomings of traditional inguinal flaps by preserving the deep fascia. In this report, we present our experience in the design and clinical application of the superficial circumflex iliac artery perforator flap, which we used to repair multiple defects in the hand.
From January 2015 to December 2020, 41 patients received free superficial circumflex iliac artery perforator flap to repair multiple hand defects. All flaps were carefully designed according to the hand defect including 21 single and 20 bilobed flaps. The area of the donor area is 2.5 cm × 3.0cm∼8.0 cm × 6.5 cm. We followed up all patients regularly and completed standardized assessments of outcomes based on post-reconstruction hand function and esthetic scores.
41 cases of flaps survived completely.3 cases of vascular crisis was relieved after surgical exploration, 1 case of mild distal necrosis was healed after dressing change, 1 case of pigmentation happened. There were 41 patients, 27 males and 14 females, with an average age of 40.5 years (4 to 59 years old). The defects included 20 cases opisthenars and 21 cases palms. The wounds were irregular, with exposed or damaged tendons, nerves or bones. All flaps were followed for a mean of 10.5 months (3 to 15 months). The functional and esthetic outcomes were satisfactory for all flaps without complications such as hand spasms, adhesions and scar contractures CONCLUSION: The superficial circumflex iliac artery perforator flap's donor site was concealed, relatively stable perforators, easy dissection. Recipient site condition was good and acceptable for the patients. It is a significant choice for multiple hand defects.
手部多处缺损的重建与修复是功能、感觉和美学的综合体现。采用旋髂浅动脉穿支皮瓣进行重建已逐渐流行，该皮瓣通过保留深筋膜克服了传统腹股沟皮瓣的固有缺点。在本报告中，我们介绍了旋髂浅动脉穿支皮瓣的设计及临床应用经验，我们使用该皮瓣修复手部多处缺损。
2015年1月至2020年12月，41例患者接受游离旋髂浅动脉穿支皮瓣修复手部多处缺损。所有皮瓣均根据手部缺损情况精心设计，其中单叶皮瓣21例，双叶皮瓣20例。供区面积为2.5 cm×3.0cm至8.0 cm×6.5 cm。我们对所有患者进行定期随访，并根据重建后的手部功能和美学评分完成标准化的结果评估。
41例皮瓣全部存活。3例血管危象经手术探查后缓解，1例轻度远端坏死经换药后愈合，1例出现色素沉着。41例患者中，男性27例，女性14例，平均年龄40.5岁（4至59岁）。缺损包括20例手背和21例手掌。创面不规则，伴有肌腱、神经或骨骼外露或损伤。所有皮瓣平均随访10.5个月（3至15个月）。所有皮瓣的功能和美学效果均令人满意，未出现手部痉挛、粘连和瘢痕挛缩等并发症。结论：旋髂浅动脉穿支皮瓣供区隐蔽，穿支相对稳定，解剖容易。受区条件良好，患者可接受。它是手部多处缺损的重要选择。
