Free superficial iliac circumflex artery flap for coverage of dorsal skin defect of the fingers

Abstract

Objective To evaluate the efficacy of free transfer of superficial iliac circumflex artery flap in covering dorsal soft tissue defects of the thumb and fingers. Methods From September 2010 to October 2015, 21 cases of soft tissue defects in the dorsal aspect of the thumb and fingers were treated with free transfer of the superficial iliac circumflex artery flap. The size of the soft tissue defects ranged from 2.5 cm×3.0 cm to 3.0 cm×5.5 cm. All the cases had different degrees of bone or tendon exposure, with phalangeal fracture in 2 cases and bone and extensor tendon defects in 3 cases. The size of the flaps harvested ranged from 3.0 cm×3.5 cm to 3.5 cm×5.5 cm. The donor sites were closed directly. Results All the flaps survived after the operation. Tension blister occurred in 1 case, and the flap survived after decompression with stitch removal. Primary healing was obtained in the recipient sites and the donor sites in all cases. Secondary de-bulky surgery was performed in 5 cases 3 month after the flap transfer which achieved the good flap appearance. Postoperative follow-up period ranged from 6 to 18 months, the average time being 11 months. All the flaps survived with fine texture, elasticity and aesthetics. According to the functional evaluation standards issued by Hand Surgery Society of the Chinese Medical Association, the results were excellent in 16 cases, good in 4 cases, and fair in 1 case. The two-point discrimination ranged from 8 to 13 mm, with the average being 9 mm. Conclusion Free superficial iliac circumflex artery flap transfer is an effective procedure to repair soft tissue defects on the dorsal side of the thumb and fingers with the excellent function and appearance and minor donor site morbidity. Key words: Finger injuries; Surgical flaps; Superficial iliac circumflex artery; Soft tissue defect