Abstract
ObjectivesThis paper describes imaging and anatomical features, in order to assess the feasibility of superficial circumflex iliac artery perforator (SCIP) flap with a single-pedicle bilobed design for multi-digit skin and soft tissue reconstruction in pediatric patients.MethodsA total of 7 pediatric patients who were being treated with free single-pedicle bilobed SCIP flap reconstruction for multi-digit defects were included in this study. The details of the clinical features were collected, and the following were successively analyzed: the preoperative computed tomographic angiography (CTA) and color Doppler sonography (CDS) examinations for flap design, the intraoperative anatomy for perforator vessel, defect reconstruction and interphalangeal range of motion (ROM) and tactile sense, pain sense, and two-point discrimination recovery results.ResultsCTA and CDS performed preoperatively could accurately and rapidly identify the position, location and course of the superficial circumflex iliac artery perforator. All wounds healed by the first follow-up and no complications occurred at the follow-up visit. All flaps survived, the patients achieved proximal interphalangeal joint (PIP) ranges of motions (ROM) from 80 to 100° and distal interphalangeal joint (DIP) ROM from 65 to 80°. The tactile sense and pain sense recovered, and average of the two-point discrimination scores was 9.3 mm (range 7–12 mm). The donor area was primarily sutured with a tidy scar in the underwear region.ConclusionCTA and CDS performed preoperatively are accurate and intuitive methods for assessing the location and course of SCIP. The SCIP flap is suitable for pediatric patients due to its small vessel caliber, specific functional and esthetic benefits. It can be designed in a lobulated fashion in order to repair two or more wounds during one surgery. We suggest that the free single-pedicle bilobed SCIP flap should be considered a good option choice for multi-digit defect reconstruction in pediatric patients in the clinic.
Highlights
The hands play a very important role in daily life and routine work; the finger and dorsum of the hand are most frequently subjected to soft tissue injuries of the skin [1, 2]
With the continuous improvements in microsurgery technology, the free superficial circumflex iliac artery perforator(SCIP) flap, which evolved from the traditional groin flap, has achieved many outstanding advantages, such as its softness, flexibility, limited damage to the donor area, minimal donor site morbidity, and scar concealment [6]
The SCIP flap is a suitable candidate owing to its unique characteristics, such as its thinness and pliability, the small caliber of the vessels, and the design flexibility; it can reduce operation difficulty resulting from nonconformity of the vessel caliber
Summary
The hands play a very important role in daily life and routine work; the finger and dorsum of the hand are most frequently subjected to soft tissue injuries of the skin [1, 2]. With the continuous improvements in microsurgery technology, the free superficial circumflex iliac artery perforator(SCIP) flap, which evolved from the traditional groin flap, has achieved many outstanding advantages, such as its softness, flexibility, limited damage to the donor area, minimal donor site morbidity, and scar concealment [6] At present, this flap is gradually applied for the repair of various skin and soft tissue defects in different sites, such as the head and neck, external auditory canal, limbs, perineum and penis, and relevant research has been reported in succession [6,7,8,9,10]. The flap can be designed with a lobulated appearance in order to repair two or more wounds simultaneously by anastomosing one group of blood vessels [11]
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