JOURNAL ARTICLE

[Clinical application of micro transverse flap pedicled with superficial palmar branch of radial artery from palmar wrist to repair skin defect of finger]

Min Zhao, Dehu Tian, Xinzhong Shao, Dacun Li, Jingda Liu, Liang Zhao, Hailei Li, Xiaolei Wang, Wentong Zhang, Jianfeng Li
Chinese Journal of Reparative and Reconstructive Surgery 2013, 27 (12): 1475-9
24640369

OBJECTIVE: To investigate the clinical application of micro transverse flap pedicled with superficial palmar branch of radial artery from palmar wrist to repair skin defect of finger.

METHODS: Twenty-six cases (26 fingers) with skin defect of finger were repaired with micro transverse flap pedicled with superficial palmar branch of radial artery from palmar wrist between December 2011 and February 2013. There were 20 males and 6 females with the average age of 31.5 years (range, 20-56 years). The causes of injury included cutting injury in 20 cases and crushing injury in 6 cases. The time from injury to admission was 1-5 hours with an average of 2 hours. Injured fingers included thumb in 6 cases, index finger in 6 cases, middle finger in 6 cases, ring finger in 4 cases, and little finger in 4 cases; the locations were the dorsal side of the finger in 6 cases, lateral side in 6 cases, and the volar of the finger tip in 14 cases; there were 4 cases on the proximal phalangeal skin, 8 cases on the middle phalangeal skin, and 14 cases on the distal phalangeal skin. The defect area ranged from 2.0 cm x 1.5 cm to 4.0 cm x 2.0 cm, and the flap area ranged from 2.5 cm x 2.0 cm to 4.5 cm x 2.5 cm. All the donor sites were directly sutured.

RESULTS: The flaps of 25 cases survived well after operation, and wound healed by first intention; 1 case had partial necrosis and the wound had a scar healing by changing dressing. All cases were followed up 6-12 months (mean, 10 months). The color and appearance of the flaps were satisfactory with tender texture. The two-point discrimination of the flap was 5-8 mm (mean, 6.8 mm). The donor sites healed primarily without scar contracture and limitation of wrist flexion or extension.

CONCLUSION: The micro transverse flap pedicled with superficial palmar branch of radial artery from palmar wrist is a good option to repair skin defect of finger. It has the advantages of hidden donor site, the same operative field, great comparability of flap and finger skin, and it can be used as a vascularized tendon or nerve graft.

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