Singh Apoorva Pratap, Dixit Pawan Kumar, Kala Prakash Chandra, Agrawal Dushyant, Katrolia Deepti, Karmakar Shilpi, Singla Priyanka, Humnekar Akhilesh
From the Department of Burns and Plastic Surgery.
Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, India.
Ann Plast Surg. 2024 Oct 1;93(4):443-446. doi: 10.1097/SAP.0000000000004031. Epub 2024 Aug 1.
Hand injuries pose challenges due to complexity and aesthetic-functional concerns. Dorsum of hand injuries are difficult to treat due to thin skin cover and increased propensity to exposure of underlying structures. Perforator-based flaps can provide better outcomes with minimal donor site morbidity. This study aims to bridge the gap in anatomical knowledge and explore the potential benefits of dorsal carpal artery perforator flap.
A prospective study was done from July 2021 to June 2023, focused on study of dorsal carpal artery perforators on 12 fresh frozen cadaveric hands. Anatomical study involved injection of red latex into arteries at the wrist, followed by dissection and measurements. During the clinical phase, we used the inferences gained from the anatomical study to identify and mark perforator of dorsal carpal arteries. We performed V-Y advancement flap based on the DCPs in 5 patients who had dorsum of hand defects due to trauma.
The study was carried out on 6 fresh frozen cadavers (12 hands). Anatomical findings revealed the anatomical location, caliber, and consistent number of dorsal carpal artery perforators supplying the dorsum of the hand arranged in 2 rows. Clinically, we applied this insight to create V-Y flaps in 5 patients with successful outcomes, thus, offering DCP-based flap as an alternative to distant flaps.
DCP-based flaps offer an efficient solution for reconstructing proximal hand defects over the dorsum, with minimal complications, enhancing our understanding of hand reconstruction options. The study's comprehensive anatomical insights and clinical outcomes contribute to improving hand defect management and surgical techniques.
手部损伤因其复杂性以及美学和功能方面的问题而具有挑战性。手背损伤由于皮肤覆盖薄且潜在结构暴露的倾向增加而难以治疗。基于穿支皮瓣能够以最小的供区并发症提供更好的治疗效果。本研究旨在弥合解剖学知识方面的差距，并探索腕背动脉穿支皮瓣的潜在益处。
2021年7月至2023年6月进行了一项前瞻性研究，重点是对12只新鲜冷冻尸体手的腕背动脉穿支进行研究。解剖学研究包括向手腕动脉注射红色乳胶，随后进行解剖和测量。在临床阶段，我们利用从解剖学研究中获得的推断来识别和标记腕背动脉穿支。我们对5例因创伤导致手背缺损的患者基于腕背动脉穿支进行了V-Y推进皮瓣手术。
该研究在6具新鲜冷冻尸体（12只手）上进行。解剖学发现揭示了供应手背的腕背动脉穿支的解剖位置、管径和恒定数量，其排列成2排。临床上，我们将这一认识应用于5例患者以创建V-Y皮瓣，取得了成功的结果，从而提供了基于腕背动脉穿支的皮瓣作为远处皮瓣的替代方案。
基于腕背动脉穿支的皮瓣为重建手背部近端缺损提供了一种有效的解决方案，并发症最少，增强了我们对手部重建选择的理解。该研究全面的解剖学见解和临床结果有助于改善手部缺损的处理和手术技术。
