Retrospective study of flap transfer for upper limb repair

Abstract

Objective To explore treatment strategies for upper limb soft tissue defects and the advantages and disadvantages of various flaps and to analyze the causes of flap necrosis through the retrospective analysis of treatment outcomes of upper limb soft tissue defects with surgical flap repair.Methods Surgical treatments were performed in 3650 cases with upper extremity soft tissue defects from May 1997 to June 2012.37 types of a total 3724 flaps,including 2471 traditional flaps in 11 types,1015 pedicle flaps in 10 types,154 free flaps and myocutaneous flaps in 8 types were reviewed.Results All cases were follow-up from 1 month to 9 years,the average being 2.4 months.Complete survival of the flap was seen in 3606 cases,accounting for 96.83％.Complete necrosis of the flap occurred in 22 cases,accounting for 0.59％,while partial necrosis occurred in 96 cases,accounting for 2.58％.Conclusion Selection of flap transfer for upper extremity soft tissue defect should be based on proper surgical indications.Timing of the surgery is also important.Venous drainage of the reverse island flap is the decisive factor for flap survival.Flap choice should be individualized. Key words: Upper extremity; Surgical flaps; Soft tissue defects; Retrospective studies