Using high and low polar skin branches-blood supplied femoral anterolateral flap to repair large defects of skin soft tissues

Abstract

Objective To investigate the clinical effects of using the high and low polar skin branches-dual blood supplied femoral anterolateral flap to repair large defects of skin soft tissues in patients lacked of musculocutaneous-flap-1 perforating branch. Methods Nine patients with large defects of skin soft tissues in lower limbs lacked of musculocutaneous-flap-1 perforating branch (high and low polar skin branches, 6 males and 3 females) , who were hospitalized in our hospital between July 2008 and July 2014, were included in the study. There were 9 cases of low polar skin branch-flap induced by the descending branch of the lateral femoral circumflex artery, 5 of high polar skin branch-flap induced by the ascending branch of the lateral femoral circumflex artery, 2 induced by the starting point of the descending branch of the lateral femoral circumflex artery, and 2 induced by the transverse branch of the lateral femoral circumflex artery. Using the high and low polar skin branches-blood supplied flap, 5 cases of large defects of pretibial skin soft tissues, 3 of foot degloving injury induced large defects of skin soft tissues, and 1 of large defects ofskin soft tissues in the wrist and hand back of foreman were repaired. All the defects area was from 10 cm×26 cm to 12 cm×35 cm. Results All the 9 flaps were survived. One case of flap infection was induced by tendonitis, and the wound was healed by anti-infection and debridement. There were no cases of arterial or venous crisis. The follow-up was 6-24 months, and the mean follow-up was 12 months. The blood supply of the flap was good, with normal color, good elasticity and recovery, and satisfactory appearance. No complications occurred at the donor sites. The quadriceps strength did not decline. Conclusion When the femoral anterolateral flap is lack of musculocutaneous-flap-1 perforating branch with large resection area, using the high and low polar skin branches-blood supply to resect and transplant the flap is an ideal method with good blood supply and high survival rate. Key words: Surgical flaps; Skin transplantation; Soft tissue injuries