Using the special type of free tissue flap based on radial artery superficial palmar branch from palmar wrist repairing complex soft tissue defects of the digitals

Abstract

Objective To investigate the clinical outcomes of repairing complex soft tissue defects of the fingers with transplantation of the special type of free tissue flap based on radial artery superficial palmar branch from palmar wrist. Methods Thirteen cases with complex soft tissue defects of fingers were repaired with free tissue flap based on radial artery superficial palmar branch from palmar wrist between March, 2012 to January, 2015. Skin and soft tissue defect 1.5 cm × 3.0 cm to 2.5 cm × 6.0 cm, accompanied by bilateral segmental artery defect and injured finger blood circulation disorder in 4 cases; with unilateral finger artery and nerve defect in 2 cases; with extensor tendon defect in 4 cases; with of the artery, nerves or tendons. The size of the skin flap was 2.0 cm × 3.0 cm-3.5 cm × 6.5 cm, and the donor site was primary closed, finger flexor tendon defect, finger artery defect in 3 cases, respectively to radial palmar superficial branch of the transverse crease of the wrist portion of the flow-through flap, carrying the median nerve of the palmar cutaneous branch of the chimeric flap, carrying palm longus chimeric flap, carrying palm longus chimeric flow-through flap to repair the wound, and defect and reconstruction. Results All the flaps survived completely, the wounds and the donor sites were healed by first intention. All the patients were followed up from 6 to 15 months (average 9.5 months). The color and appearance of the flaps were satisfactory with tender texture. The scar of donor district was not conspicuous. The twopoint discrimination of the flap was 5.5-9.5 mm (mean, 7.2 mm). According to the Chinese Medical Association Society of hand surgery of thumb and finger reconstruction function evaluation standard trial evaluation, were excellent in 11 cases, good in 1 case, medium in 1 case. Conclusion Using the special type of free tissue flap based on radial artery superficial palmar branch from palmar wrist can repair of finger skin defect, and reconstruction of the defect of digital artery, nerve or tendon tissue in one stage. It is a method for repairing complicated soft tissue defects of finger, with the advantages of shortening the course of disease and satisfied recovering of the appearance and function of the finger. Key words: Superficial palmar branch of the radial artery; Perforate flap; Digitals; Soft tissue defect; Repair