CLINICAL APPLICATION OF FOREARM INTEROSSEOUS DORSAL ARTERY PERFORATOR SUBLOBE FLAPS TO REPAIR TWO WOUNDS IN DORSAL HAND OR WRIST_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANGBaoyun ,  TANGXiujun , WEIZairong , WANGDali , SUNGuangfeng , WANGBo , QIJianping , JINWenhu

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：

Forearm interosseous dorsal artery perforator; Sublobe flap; Dorsal hand; Wrist; Multiple wounds; Wound repair

DOI：

10.7507/1002-1892.20140111

Video：

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Objective To investigate the clinical application of the forearm interosseous dorsal artery perforator sublobe flaps in repairing two wounds in dorsal hand or wrist. Methods Between October 2009 and October 2012, 12 patients with two wounds in the dorsal hand or wrist were included in the study. There were 4 cases of skin defects (grade IV) and bone exposure caused by machine injury, 3 cases of skin defects with bone and tendon exposure caused by traffic accident, and 3 cases of skin defect and tendon exposure caused by crash injury of heavy object, with a duration of 3-12 hours (mean, 6 hours) between injury and admission; defects in the wrist and tendon exposure were caused by tumor resection in 2 cases. Four cases had metacarpal fractures. The size of larger skin and soft tissue defects ranged from 4.0 cm×3.5 cm to 5.0 cm×3.0 cm, and the size of smaller defects was from 2.5 cm×2.0 cm to 4.0 cm×3.0 cm. The flap size was from 6 cm×4 cm to 8 cm×3 cm and 3.0 cm×2.5 cm to 5.0 cm×3.0 cm. The donor sites were directly sutured or repaired with free skin graft. Results All the flaps survived, and wound healed in first stage. All the cases were followed up 6-36 months (mean, 20 months). The flaps had good color and texture. Three cases underwent secondary surgery of thinning the flaps. At last follow-up, two-point discrimination of flaps was 10-14 mm, 12 mm on average. According to function standard for evaluation of upper extremity with total active motion of the fingers from the Hand Surgery Society of Chinese Medical Association, the results were excellent in 10 cases, and good in 2 cases. Conclusion Forearm interosseous dorsal artery perforators sublobe flaps can be used to repair two wounds in the dorsal hand or wrist simultaneously, and it has the advantages of simple operation, less injury at donor site, and reliable blood supply.

Citation： WANGBaoyun, TANGXiujun, WEIZairong, WANGDali, SUNGuangfeng, WANGBo, QIJianping, JINWenhu. CLINICAL APPLICATION OF FOREARM INTEROSSEOUS DORSAL ARTERY PERFORATOR SUBLOBE FLAPS TO REPAIR TWO WOUNDS IN DORSAL HAND OR WRIST. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(4): 495-498. doi: 10.7507/1002-1892.20140111 Copy

1.	宋鐵山, 李鴻文, 彭云滔, 等. 應用骨間背側肌皮瓣修復手部創面. 中華顯微外科雜志, 2012, 35(1):55-56.
2.	高建明, 劉云鵬, 李宏, 等. 皮瓣修復在手外科臨床應用277例報道. 實用手外科雜志, 2010, 24(2):114-115.
3.	戚建武, 柴益銅, 王科杰, 等. 游離腹股溝皮瓣修復手部皮膚缺損. 中華手外科雜志, 2013, 29(5):271-273.
4.	郭曉波, 蘇薇潔, 朱文, 等. 前臂背側骨間動脈穿支逆行島狀皮瓣修復手部皮膚和軟組織缺損. 上海交通大學學報:醫學版, 2011, 31(7):992-995.
5.	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):512-515.
6.	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.
7.	魏在榮, 鄭和平, 王達利, 等. 手足部皮瓣的解剖與臨床應用. 天津:天津科學技術出版社, 2011:102-103.
8.	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.
9.	Costa H, Pinto A, Zenha H. The posterior interosseous flap-a prime technique in hand reconstruction. The experience of 100 anatomical dissections and 102 clinical cases. J Plast Reconstr Aesthet Surg, 2007, 60(7):740-747.
10.	Giunta R, Lukas B. Impossible harvest of the posterior interosseous artery flap:a report of an individualised salvage procedure. Br J Plast Surg, 1998, 51(8):642-645.
11.	Kola N, Isaraj S, Xhepa G, et al. Posterior interosseous forearm flap in reconstruction of first web space. Ann Burns Fire Disas, 2009, 22(2):104-106.
12.	王欣, 胡浩良, 王勝偉, 等. 前臂骨間后動脈穿支皮瓣的解剖學研究. 解剖與臨床, 2011, 16(1):69-70.
13.	呂乾, 朱躍良, 梅良斌, 等. 前臂骨間背側動脈穿支游離皮瓣修復手指創面. 創傷外科雜志, 2011, 14(4):324-325.
14.	許亞軍, 孫振中, 張志海, 等. 背側骨間動脈逆行島狀皮瓣皮支血管的臨床分型及應用體會. 實用手外科雜志, 2010, 24(3):175-177.
15.	王寶云, 唐修俊, 魏在榮, 等. 改良肋間動脈穿支蒂胸腹部皮瓣修復前臂創面. 中國修復重建外科雜志, 2014, 28(1):125-126.
16.	Akinci M, Ay S, Kamiloglu S, et al. The reverse posterior interosseous flap:a solution for necrosis based on a review of 87 case. J Plast Reconstr Aesthet Surg, 2006, 59(2):148-152.
17.	閆濤, 黎立, 喬為民, 等. 前臂骨間背側動脈逆行島狀皮瓣修復手部創面. 中國修復重建外科雜志, 2011, 25(3):377-378.

1. 宋鐵山, 李鴻文, 彭云滔, 等. 應用骨間背側肌皮瓣修復手部創面. 中華顯微外科雜志, 2012, 35(1):55-56.
2. 高建明, 劉云鵬, 李宏, 等. 皮瓣修復在手外科臨床應用277例報道. 實用手外科雜志, 2010, 24(2):114-115.
3. 戚建武, 柴益銅, 王科杰, 等. 游離腹股溝皮瓣修復手部皮膚缺損. 中華手外科雜志, 2013, 29(5):271-273.
4. 郭曉波, 蘇薇潔, 朱文, 等. 前臂背側骨間動脈穿支逆行島狀皮瓣修復手部皮膚和軟組織缺損. 上海交通大學學報:醫學版, 2011, 31(7):992-995.
5. 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):512-515.
6. 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.
7. 魏在榮, 鄭和平, 王達利, 等. 手足部皮瓣的解剖與臨床應用. 天津:天津科學技術出版社, 2011:102-103.
8. 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.
9. Costa H, Pinto A, Zenha H. The posterior interosseous flap-a prime technique in hand reconstruction. The experience of 100 anatomical dissections and 102 clinical cases. J Plast Reconstr Aesthet Surg, 2007, 60(7):740-747.
10. Giunta R, Lukas B. Impossible harvest of the posterior interosseous artery flap:a report of an individualised salvage procedure. Br J Plast Surg, 1998, 51(8):642-645.
11. Kola N, Isaraj S, Xhepa G, et al. Posterior interosseous forearm flap in reconstruction of first web space. Ann Burns Fire Disas, 2009, 22(2):104-106.
12. 王欣, 胡浩良, 王勝偉, 等. 前臂骨間后動脈穿支皮瓣的解剖學研究. 解剖與臨床, 2011, 16(1):69-70.
13. 呂乾, 朱躍良, 梅良斌, 等. 前臂骨間背側動脈穿支游離皮瓣修復手指創面. 創傷外科雜志, 2011, 14(4):324-325.
14. 許亞軍, 孫振中, 張志海, 等. 背側骨間動脈逆行島狀皮瓣皮支血管的臨床分型及應用體會. 實用手外科雜志, 2010, 24(3):175-177.
15. 王寶云, 唐修俊, 魏在榮, 等. 改良肋間動脈穿支蒂胸腹部皮瓣修復前臂創面. 中國修復重建外科雜志, 2014, 28(1):125-126.
16. Akinci M, Ay S, Kamiloglu S, et al. The reverse posterior interosseous flap:a solution for necrosis based on a review of 87 case. J Plast Reconstr Aesthet Surg, 2006, 59(2):148-152.
17. 閆濤, 黎立, 喬為民, 等. 前臂骨間背側動脈逆行島狀皮瓣修復手部創面. 中國修復重建外科雜志, 2011, 25(3):377-378.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF FOREARM INTEROSSEOUS DORSAL ARTERY PERFORATOR SUBLOBE FLAPS TO REPAIR TWO WOUNDS IN DORSAL HAND OR WRIST

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