Free multiple flaps from the foot based on one pedicle for repairing multiple soft tissue defects of the hand

Abstract

Objective To introduce the surgical techniques and evaluate the clinical outcomes of free multiple flaps firm the foot supplied with one vascular pedicle for repairing multiple soft tissue defects of the hand. Methods Twelve patients with multiple soft tissue defects of the hand were treated with transfer of multiple flaps from the foot based on one vascular pedicle.Serial flaps based on the dorsalis pedis artery were used to repair the soft tissue defects on the palm and dorsum of the hand in 5 cases.Serial flaps based on the dorsalis pedis artery and the dorsal digital artery were transferred to cover the palm and finger defects in 3 cases.For the other 4 cases,the soft tissue defects in the adjacent fingers were repaired with serial flaps based on the first dorsal digital artery.The donor site was covered with full-thickness skin graft from the lower abdomen.Results All 27 flaps in the 12 cases survived with primary wound healing.Donor site skin graft had partial necrosis in 2 cases,which was healed after dressing change.The patients were follow-up for 6 to 36 months,with an average of 14 months.It was found that the hand function recovered satisfactorily.The flaps had fine texture,natural appearance and no swelling.The sensory function was recovered to S2 to S3.The foot donor site healed well without ulceration and dcer formation and no effect on walking function was noted. Conclusion It is a better way to repair multiple skin defects of the hand using multiple flaps from the foot based on one vascular pedicle.Its advantage is that multiple skin defects can be repaired in one operation. Key words: Surgical flaps; Hand; Injury; Tissue transplantation; Foot