Clinical application of a large flow-through venous flap

Abstract

To investigate the clinical effects of a large flow-through venous flap. Between January 2012 and January 2015,this flap was used in 9 patients with upper limb injury to reconstruct artery defect and large skin and soft tissue defect. The donor sites were covered with free skin grafts. The skin and soft tissue defects size ranged from 7.0 cm × 10.0 cm to 9.5 cm × 18.0 cm (average 9.2 cm× 12.0 cm). The flaps size ranged from 9.0 cm × 12.0 cm-11.5 cm × 20.0 cm (average 10.3 cm × 13.5 cm).Except 2 cases of small area necrosis occurred in the distal end of the flap, which healed after dressing change; the other 7 flaps survived completely. The donor wounds healed primarily. Postoperative patients were followed up for 12-26 months (mean 14.5 months). Flap appearance, texture and thickness were similar to the surrounding normal tissue. According to the sensory function evaluation standard formulated by the British Medical Research Council in 1954,the result of skin flap sensory evaluation was assessed as S2 in two cases,S3 in four cases,S3 in three cases, with excellent and good rate as 77.8％.According to the assessment standard for upper limb function issued by Chinese Medical Association of hand surgery, the limb function were assessed as excellent in 6 cases, good in 2 cases, poor in 1 case, with the excellent and good rate as 88.9％. The large flowthrough venous flap has the advantages of simple operation, minimal donor site morbidity and satisfactory appearance. It is a feasible method to repair the wound at upper limb with artery defect.