Free adipofascial flap from peroneal perforator artery for repair of hand skin defects

Abstract

Objective To explore the surgical technique and clinical outcomes of applying the free adipofascial flap nourished by musculocutaneous perforators of the peroneal artery to repair soft tissue defects of the hand. Methods Six cases of skin defects in the hand were treated from December 2007 to October 2009 with free peroneal artery perforator fascial flap. The size of the raised flaps ranged from 5.0 cm × 4.5 cm to 10 cm × 7 cm. In most cases the musculocutaneous branch was chosen as the vascular pedicle for anastomosis.The blood vessels were anastomosed in an end-to-side fashion. The transferred fascial flap was covered with split thickness skin graft, while the donor site was closed directly. Results All the adipofascial flaps survived uneventfully. The skin graft over the fascial flap showed over 90% survival in 4 cases and 80% survival in 2 cases after 7 days. Follow-up time ranged from 3 to 12 months. Flap bulkiness was seen in one case which underwent debulking procedure 3 months later. The appearance of other 5 cases was satisfactory with only slight flap bulkiness. Only a linear scar was left at the calf donor site. Conclusion The free adipofascial flap was a modification of peroneal perforator flaps to minimize morbidity and improve cosmoses of the donor site. The adipofascial flap can also fill the void caused by soft tissue defects and provide better condition for functional reconstruction. Key words: Hand injuries; Surgical flaps; Adipofascial flap