CLINICAL APPLICATION OF REPAIRING WOUND IN WRIST WITH FLAP SUPPORTED BY PERFORATING BRANCH OF FOREARM RADIAL ARTERY AND CATENA-FORM BLOOD VESSEL_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUPeng ,  TANGXiujun , WEIZairong , WANGDali , SUNGuangfeng , WANGBaoyun , ZANQin

Department of Burns and Plastic Surgery, the Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563000, P. R. China;

Corresponding?author：

TANGXiujun, Email: xiujunsszx@163.com

Keywords：

Perforator flap; Superior wrist perforator of radial artery; Catena-form blood vessel; Wound repair

DOI：

10.7507/1002-1892.20140110

Video：

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Objective To explore the clinical application of the flap supported by perforating branch of the radial artery superior wrist catena-form blood vessel in repairing hand and wrist wound. Methods Between March 2010 and March 2013, 24 cases of severe wounds in wrist were repaired with the flap supported by perforating branch of forearm radial artery and catena-form blood vessel. There were 15 males and 9 females, aged 19-54 years (mean, 37 years). In 22 patients with trauma, there were 9 cases of machine injury, 5 cases of traffic accident injury, 5 cases of crash injury of heavy objects, 1 case of sharp instrument injury, and 2 cases of electrical injury, with a mean disease duration of 11 days (range, 2-20 days). In 2 patients with tumor excision wound, there were 1 case of right forearm liposarcoma and 1 case of left forearm squamous-cell carcinoma, with the disease duration of 7 days and 3 months, respectively. All cases complicated by bone and tendon exposure. The size of defect was 4.5 cm×4.0 cm to 10.0 cm×7.5 cm, and the size of the flap was 6.0 cm×4.0 cm to 20.0 cm×8.5 cm. The donor site was directly sutured or repaired by skin graft. Results Partial flap necrosis occurred in 1 case, and was cured after dressing change; the other flaps survived, and primary healing of incision was obtained. The patients were followed up 6-36 months (mean, 20 months). The flap featured good color and texture, and also recovered protective sensation at 6 months after operation, with a mean two-point discrimination of 12 mm (range, 11-14 mm). No ulcers of the flap was observed. At last follow-up, according to Hand Surgery Society of Chinese Medical Association for functional evaluation of upper limb, the function was rated as excellent in 19 cases, good in 4 cases, and fair in 1 case. Conclusion The flap supported by perforating branch of forearm radial artery and catena-form blood vessel can be used to repair wound in wrist, which has no injury to the radial artery, and it also could be used for the patients with ulnar and radial artery injuries. Thus it is an ideal method to repair wound in the wrist because the operation is simple, and the flap has good appearance and texture.

Citation： HUPeng, TANGXiujun, WEIZairong, WANGDali, SUNGuangfeng, WANGBaoyun, ZANQin. CLINICAL APPLICATION OF REPAIRING WOUND IN WRIST WITH FLAP SUPPORTED BY PERFORATING BRANCH OF FOREARM RADIAL ARTERY AND CATENA-FORM BLOOD VESSEL. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(4): 491-494. doi: 10.7507/1002-1892.20140110 Copy

1.	唐修俊, 魏在榮, 王波, 等. 改良帶蒂旋髂淺動脈皮瓣修復手部及前臂創面. 中國修復重建外科雜志, 2012, 26(8):943-945.
2.	雷磊, 米增法, 孟紅陽, 等. 橈動脈逆行島狀皮瓣修復手深度燒傷. 實用醫學雜志, 2013, 29(2):330.
3.	楊衛璽, 李春江, 王一兵, 等. 游離上臂外側皮瓣修復手部深度燒傷. 中華顯微外科雜志, 2010, 33(5):436.
4.	Zhang YX, Qian Y, Pu Z, et al. Reverse bipaddle posterior interosseous artery perforator flap. Plast Reconstr Surg, 2013, 131(4):552e-562e.
5.	丁自海, 王增濤, 鐘世鎮. 皮瓣解剖學研究的三個階段. 中華顯微外科雜志, 2010, 33(3):180-181.
6.	索巖, 魏壯, 劉飆, 等. 橈動脈穿支皮瓣修復手及腕部皮膚缺損. 實用手外科雜志, 2012, 26(3):263-264.
7.	魏在榮, 鄭和平, 王達利. 手足部皮瓣的解剖與臨床應用. 天津:天津科學技術出版社, 2012:133-135, 151-154.
8.	謝慶平, 郭恩琪, 晉培紅, 等. 改良橈動脈穿支皮瓣在修復額面部組織缺損中的應用. 中華顯微外科雜志, 2010, 33(1):6-8.
9.	張世民, 顧玉東, 侯春林, 等. 腕部血管網的解剖基礎及其與前臂遠端蒂皮瓣的關系. 中國臨床解剖學雜志, 2002, 20(5):345-347.
10.	潘達德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3):130-135.
11.	張發惠, 鄭和平. 構建3種低旋轉軸點的前臂皮神經-淺靜脈營養血管遠端蒂復合瓣的解剖學實驗. 中國臨床康復, 2005, 9(46):79-83.
12.	Jeng SF, Wei FC. The distally based forealm island flap in hand reconstruction. Plast Reconstr Surg, 1998, 102(2):400-406.
13.	Chang SM. The pedicle of neurocutaneous island flaps. Plast Reconstr Surg, 1996, 98(2):374-376.
14.	張世民, 徐達傳, 顧玉東, 等. 鏈型皮瓣的血管基礎及臨床意義. 中國臨床解剖學雜志, 2004, 22(1):13-16.
15.	張世民, 唐茂林, 章偉文, 等. 中國穿支皮瓣的名詞術語與臨床應用原則共識(暫定稿). 中華顯微外科雜志, 2012, 35(2):89-92.
16.	Mateev MA, Ogawa R, Trunov L, et al. Shape-modified radial artery perforator flap method:analysis of 112 cases. Plast Reconstr Surg, 2009, 123(5):1533-1542.
17.	李澤龍, 謝逸波, 曾波, 等. 貴要靜脈-前臂內側皮神經營養血管皮瓣的臨床應用. 中華顯微外科雜志, 2006, 29(1):68-69.
18.	唐修俊, 周信榮, 祁建平, 等. 三面會師法切取脛后動脈高位穿支蒂皮瓣修復小腿中下段骨外露. 遵義醫學院學報, 2011, 34(5):512-514.

1. 唐修俊, 魏在榮, 王波, 等. 改良帶蒂旋髂淺動脈皮瓣修復手部及前臂創面. 中國修復重建外科雜志, 2012, 26(8):943-945.
2. 雷磊, 米增法, 孟紅陽, 等. 橈動脈逆行島狀皮瓣修復手深度燒傷. 實用醫學雜志, 2013, 29(2):330.
3. 楊衛璽, 李春江, 王一兵, 等. 游離上臂外側皮瓣修復手部深度燒傷. 中華顯微外科雜志, 2010, 33(5):436.
4. Zhang YX, Qian Y, Pu Z, et al. Reverse bipaddle posterior interosseous artery perforator flap. Plast Reconstr Surg, 2013, 131(4):552e-562e.
5. 丁自海, 王增濤, 鐘世鎮. 皮瓣解剖學研究的三個階段. 中華顯微外科雜志, 2010, 33(3):180-181.
6. 索巖, 魏壯, 劉飆, 等. 橈動脈穿支皮瓣修復手及腕部皮膚缺損. 實用手外科雜志, 2012, 26(3):263-264.
7. 魏在榮, 鄭和平, 王達利. 手足部皮瓣的解剖與臨床應用. 天津:天津科學技術出版社, 2012:133-135, 151-154.
8. 謝慶平, 郭恩琪, 晉培紅, 等. 改良橈動脈穿支皮瓣在修復額面部組織缺損中的應用. 中華顯微外科雜志, 2010, 33(1):6-8.
9. 張世民, 顧玉東, 侯春林, 等. 腕部血管網的解剖基礎及其與前臂遠端蒂皮瓣的關系. 中國臨床解剖學雜志, 2002, 20(5):345-347.
10. 潘達德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3):130-135.
11. 張發惠, 鄭和平. 構建3種低旋轉軸點的前臂皮神經-淺靜脈營養血管遠端蒂復合瓣的解剖學實驗. 中國臨床康復, 2005, 9(46):79-83.
12. Jeng SF, Wei FC. The distally based forealm island flap in hand reconstruction. Plast Reconstr Surg, 1998, 102(2):400-406.
13. Chang SM. The pedicle of neurocutaneous island flaps. Plast Reconstr Surg, 1996, 98(2):374-376.
14. 張世民, 徐達傳, 顧玉東, 等. 鏈型皮瓣的血管基礎及臨床意義. 中國臨床解剖學雜志, 2004, 22(1):13-16.
15. 張世民, 唐茂林, 章偉文, 等. 中國穿支皮瓣的名詞術語與臨床應用原則共識(暫定稿). 中華顯微外科雜志, 2012, 35(2):89-92.
16. Mateev MA, Ogawa R, Trunov L, et al. Shape-modified radial artery perforator flap method:analysis of 112 cases. Plast Reconstr Surg, 2009, 123(5):1533-1542.
17. 李澤龍, 謝逸波, 曾波, 等. 貴要靜脈-前臂內側皮神經營養血管皮瓣的臨床應用. 中華顯微外科雜志, 2006, 29(1):68-69.
18. 唐修俊, 周信榮, 祁建平, 等. 三面會師法切取脛后動脈高位穿支蒂皮瓣修復小腿中下段骨外露. 遵義醫學院學報, 2011, 34(5):512-514.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF REPAIRING WOUND IN WRIST WITH FLAP SUPPORTED BY PERFORATING BRANCH OF FOREARM RADIAL ARTERY AND CATENA-FORM BLOOD VESSEL

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