Department of Hand Surgery, Dongguan Chashan Hospital, Guangdong Medical University, Dongguan, 523000, China.
Eur J Med Res. 2024 May 9;29(1):275. doi: 10.1186/s40001-024-01863-y.
Large skin lesions of the upper extremity tend to be ''long and narrow'' in shape, and the currently used repair and reconstruction protocols still have some drawbacks, including difficulty in closure of the donor area, poor cosmetic appearance of the donor and recipient areas, and low flap survival rates. The ilioinguinal flap has been more widely used for repair and reconstruction of various complex conditions. In order to improve the versatility of the flap design and to achieve better aesthetic results, we report a study on the improved design of Compound SCIP flap for repairing "long and narrow" large skin defects of the upper extremity by using a modified design of the ilioinguinal flap for the procurement of perforating blood vessels and flap excision.
From April 2005 to August 2015, a total of 12 patients underwent this modified design procedure, in which the anterior branch of the fourth lumbar artery or the posterior intercostal artery was selected to provide blood supply for the perforator flap together with the superficial branch of the superficial iliac artery to meet the blood supply needs of the flap for the one-time repair of a large "long and narrow" skin defect in the upper limb. Patient demographics, flap characteristics, and associated complications were retrospectively analyzed.
3 females and 9 males were included in this study, the mean age of the patients was 31.7 years (range, 22-44 years), the mean follow-up period was 15.3 ± 5.6 months (range, 7-24 months), and all patients had complete closure of the defect site and donor area, and all flaps survived.
The Compound SCIP flap presents some advantages in repairing 'long and narrow' skin defects in the upper limb. While ensuring the survival rate of the elongated ilioinguinal flap, it amplifies the benefits of the ilioinguinal flap and enhances skin utilization. This can serve as a beneficial choice for repairing 'long and narrow' skin defects in the upper limb.
上肢的大面积皮肤损伤往往呈“长而窄”的形状，目前使用的修复和重建方案仍存在一些缺陷，包括供区难以闭合、供区和受区美容效果差、皮瓣成活率低等。髂腹股沟皮瓣已广泛应用于各种复杂情况的修复和重建。为了提高皮瓣设计的通用性，达到更好的美容效果，我们报告了一项关于通过改良髂腹股沟皮瓣设计获取穿支血管和皮瓣切除来修复上肢“长而窄”大面积皮肤缺损的复合 SCIP 皮瓣改良设计的研究。
2005 年 4 月至 2015 年 8 月，共 12 例患者接受了该改良设计，选择第四腰椎前支或肋间后动脉的前支与浅动脉的浅支共同为穿支皮瓣提供血供，以满足一次性修复上肢大面积“长而窄”皮肤缺损的皮瓣血供需求。回顾性分析患者的一般资料、皮瓣特点及相关并发症。
本研究包括 3 例女性和 9 例男性，患者平均年龄为 31.7 岁（范围，22-44 岁），平均随访时间为 15.3±5.6 个月（范围，7-24 个月），所有患者缺损部位和供区均完全闭合，所有皮瓣均存活。
复合 SCIP 皮瓣在修复上肢“长而窄”皮肤缺损方面具有一定优势。在保证狭长型髂腹股沟皮瓣成活率的同时，放大了髂腹股沟皮瓣的优势，增强了皮肤的利用率。这可以作为修复上肢“长而窄”皮肤缺损的有益选择。
