Clinical application of bilobed deep inferior epigastric perforator flap to repair degloving injury of hand

Abstract

Objective To discuss the method and clinical effect of bilobed DIEP flap for repair of degloving injuries of the hand. Methods From June, 2013 to January, 2015, the bilobed DIEP flap were designed to repair 6 cases of degloving injuries of hand, of which the small leaf flap repaired separately defect of thumb, larger leaf flap repair 2nd-5th finger and palm and dorsum. The bilobed DIEP flap design were based upon anatomic study on deep inferior epigastric artery, superior epigastric artery, intercostal artery and its anastomosis. Results The largest area of main flap was 35 cm × 12 cm, and the deputy leaves of flap was 10 cm × 7 cm. All of the 6 flaps survived. One of them experienced distal end necrosis of epidermis. But it was healed by dressing changes. All of the 6 cases were followed up for average of 12 months (range, 6-20 months). All flaps were seen with good appearance, fully recovered protective sensation and the active motion of the thumb was recovery. Moreover, the donor sites were closed directly and the appearance were satisfactory. Conclusion The bilobed DIEP flap is a satisfying choice in repairing degloving injuries of the hand in that it has reliable blood supply, can obtain the larger area of skin and leaves small injuries in targeted area. Key words: Bilobed flap; Deep inferior epigastric artery; Perforator flap; Skin degloving injury