Reconstruction of hand soft tissue defects with dorsal interosseous artery island flap

Abstract

Objective To evaluate the clinical effect of dorsal interosseous artery island flap to cover soft tissue defects of the hand. Methods Ten cases (8 males and 2 females) treated between 2009 and 2012 were included. The age was from 15 to 74 years. There were 4 patients associated with mechanical injury, 3 electric injury, 2 chronic ulcer and 1 hot crush injury. Size of the defect ranged from 3.0 cm×2.5 cm to 12.0 cm×7.0 cm, and the size of the flap ranged from 4.0 cm×3.0 cm to 13.0 cm×8.0 cm. The portable Doppler ultrasound was employed to locate the branches from the forearm dorsal interosseous artery. The dorsal interosseous retrograde artery distally based was used to repair hand soft-tissue defects. Results All the flaps survived except for some necrosis in one case which healed after dressing change. Eight patients were followed up for 3 months to 1 year and two patients were lost to follow-up. Flap had soft texture and similar color and sensation as the adjacent skin. No apparent hypertrophic scarring on the donor site was observed. Flap was slightly swollen in one case. Conclusion Dorsal interosseous artery retrograde island flap is safe and effective to repair hand soft tissue defects. Key words: Hand injuries; Arteries; Surgical flaps