FREE CROIN FLAP FOR REPAIRING DEFECTS OF DONOR AFTER TOE TISSUE TRANS PLANTATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIMuwei , LUOZhaohui , GUHannan , MALifeng , YANGYanjun ,  ZHANGZiqing

Department of Hand Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen Guangdong, 518116, P. R. China;

Corresponding?author：

ZHANGZiqing, Email: Dr-zhangzq@sina.com

Keywords：

Donor site of feet; Croin flap; Wound repair

DOI：

10.7507/1002-1892.20160044

Video：

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Objective To discuss the effectiveness of free croin flap in repairing defects of donor after toe or feet tissue flap transplantation. Methods Between March 2010 and May 2015, 23 cases of defects of donor after toe or feet tissue flap transplantation were repaired with free croin flap and followed up for more than 6 months, and the clinical data were retrospectively analyzed. There were 15 males and 8 females, with an age range from 17 to 52 years (mean, 25.6 years). All finger or soft tissue defects were caused by trauma. Defects were repaired in emergency operation with toe or feet tissue flap transplantation in 18 cases, defects were secondarily reconstructed at 3-8 months after injury in 5 cases. The defect area at the feet donor site ranged from 3 cm×3 cm to 10 cm×6 cm, all accompanied with exposure of bone, and tendon. The area of free croin flap was 3.5 cm×3.5 cm-11.0 cm×6.5 cm, the vessel of flap was anastomosed with artery and vein of foot. The inguinal donor site was sutured directly. Results The operation time was 3-9 hours (mean, 4.5 hours); the intraoperative blood loss was 50-300 mL (mean, 120 mL). Vessel crisis occurred in 1 case postoperatively; mild and moderate swelling occurred in 3 cases, with small sporadic blisters formation; free croin flap survived completely in the other cases, and primary healing was obtained at feet wound and inguinal donor sites. Twenty-three cases were followed up 6-24 months (mean, 9 months). The color and texture of the croin flaps were similar to that of the adjacent skin, no obvious scar contracture and pigmentation were observed; the patient could walk with weight loading, the two-point discrimination was 18-35 mm (mean, 26 mm) at 6 months after operation. The color, texture, and shape of reconstructed finger was good; the function of grasping and pinching recovered well; the two-point discrimination was 5.5-11.0 mm (mean, 6.5 mm) at 6 months after operation. According to upper extremity functional evaluation standard by Chinese Medical Association, the results were excellent in 18 cases and good in 5 cases. Conclusion Free croin flap can effectively repair skin and soft tissue defects of donor after toe or feet tissue flap transplantation, and good function and appearance of feet can be obtained.

Citation： LIMuwei, LUOZhaohui, GUHannan, MALifeng, YANGYanjun, ZHANGZiqing. FREE CROIN FLAP FOR REPAIRING DEFECTS OF DONOR AFTER TOE TISSUE TRANS PLANTATION. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(2): 215-218. doi: 10.7507/1002-1892.20160044 Copy

1.	?程國良. 不同形式的足趾移植拇手指再造與修復. 中華顯微外科雜志, 2002, 25(1):8-9.
2.	孫廣峰, 魏在榮, 王利達, 等. 趾腓側皮瓣游離移植修復手指掌側皮膚缺損. 中國修復重建外科雜志, 2011, 25(4):510-512.
3.	馮明錄, 何勇, 董濤, 等. 拇指軟組織缺損顯微修復治療方法分析. 中華顯微外科雜志, 2010, 33(6):517-518.
4.	侍朋舉, 張文龍, 趙剛, 等. 足背皮瓣串并聯甲復合組織瓣修復手部脫套傷伴拇指缺損. 中國修復重建外科雜志, 2015, 29(7):799-803.
5.	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.
6.	仇申強, 王增濤, 孫文海, 等. 手指再造術中甲瓣供區的修復. 中華顯微外科雜志, 2011, 34(4):272-275.
7.	王保山, 鄭曉菊, 王新宏, 等. 甲瓣切取術后創面的處理. 中華顯微外科雜志, 2009, 32(1):26-28.
8.	程鵬, 鄭元波, 李麗. 四肢組織移植后供區繼發損傷的處理方法探討. 浙江創傷外科, 2011, 16(1):65-67.
9.	侯春林. 供求同重-提高我國組織移植修復缺損及功能重建水平. 中國修復重建外科雜志, 2005, 19(7):499-500.
10.	康慶林, 柴益民, 曾炳芳, 等. 甲瓣切取術后供區創面覆蓋的方法選擇. 中華顯微外科雜志, 2007, 30(4):267-269.
11.	夏曉丹, 謝松林, 黃雄杰, 等. 股前外側穿支皮瓣修復甲瓣再造拇指足供區皮膚缺損. 中國修復重建外科雜志, 2014, 28(1):127-128.
12.	姜曉華, 馬合龍. 足拇甲瓣治療單手指脫套傷并跗外側皮瓣修復足供區. 中國美容醫學, 2012, 21(7)下:60-61.
13.	李宗軍, 肖春凌, 殷建新, 等. 腓動脈終末穿支蒂腓淺神經營養血管島狀皮瓣修復前足供區創面. 中國修復重建外科雜志, 2009, 23(2):209-211.
14.	鄭艷峰, 沈曉霞, 朱家駿, 等. 腓淺神經營養血管皮瓣修復足部供區創面的臨床應用. 中華顯微外科雜志, 2013, 36(6):572-573.
15.	魏勇, 李鈞, 童哲, 等. 跗外側皮瓣修復甲皮瓣術中趾供區的創面. 中華手外科雜志, 2010, 26(5):318.
16.	楊慶達, 張智釗, 盧家靈, 等. 改良第一趾蹼皮瓣游離移植術后供區創面的修復. 中國修復重建外科雜志, 2013, 27(10):1279-1280.
17.	徐達傳, 張世民, 唐茂林. 穿支皮瓣及相關術語的初步共識. 中華顯微外科雜志, 2011, 34(5):358-359.
18.	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.
19.	Kimura N, Satoh K, Hosaka Y. Tensor fasciae latae perforator flap. Clin Plast Surg, 2003, 30(3):439-446.

1. ?程國良. 不同形式的足趾移植拇手指再造與修復. 中華顯微外科雜志, 2002, 25(1):8-9.
2. 孫廣峰, 魏在榮, 王利達, 等. 趾腓側皮瓣游離移植修復手指掌側皮膚缺損. 中國修復重建外科雜志, 2011, 25(4):510-512.
3. 馮明錄, 何勇, 董濤, 等. 拇指軟組織缺損顯微修復治療方法分析. 中華顯微外科雜志, 2010, 33(6):517-518.
4. 侍朋舉, 張文龍, 趙剛, 等. 足背皮瓣串并聯甲復合組織瓣修復手部脫套傷伴拇指缺損. 中國修復重建外科雜志, 2015, 29(7):799-803.
5. 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.
6. 仇申強, 王增濤, 孫文海, 等. 手指再造術中甲瓣供區的修復. 中華顯微外科雜志, 2011, 34(4):272-275.
7. 王保山, 鄭曉菊, 王新宏, 等. 甲瓣切取術后創面的處理. 中華顯微外科雜志, 2009, 32(1):26-28.
8. 程鵬, 鄭元波, 李麗. 四肢組織移植后供區繼發損傷的處理方法探討. 浙江創傷外科, 2011, 16(1):65-67.
9. 侯春林. 供求同重-提高我國組織移植修復缺損及功能重建水平. 中國修復重建外科雜志, 2005, 19(7):499-500.
10. 康慶林, 柴益民, 曾炳芳, 等. 甲瓣切取術后供區創面覆蓋的方法選擇. 中華顯微外科雜志, 2007, 30(4):267-269.
11. 夏曉丹, 謝松林, 黃雄杰, 等. 股前外側穿支皮瓣修復甲瓣再造拇指足供區皮膚缺損. 中國修復重建外科雜志, 2014, 28(1):127-128.
12. 姜曉華, 馬合龍. 足拇甲瓣治療單手指脫套傷并跗外側皮瓣修復足供區. 中國美容醫學, 2012, 21(7)下:60-61.
13. 李宗軍, 肖春凌, 殷建新, 等. 腓動脈終末穿支蒂腓淺神經營養血管島狀皮瓣修復前足供區創面. 中國修復重建外科雜志, 2009, 23(2):209-211.
14. 鄭艷峰, 沈曉霞, 朱家駿, 等. 腓淺神經營養血管皮瓣修復足部供區創面的臨床應用. 中華顯微外科雜志, 2013, 36(6):572-573.
15. 魏勇, 李鈞, 童哲, 等. 跗外側皮瓣修復甲皮瓣術中趾供區的創面. 中華手外科雜志, 2010, 26(5):318.
16. 楊慶達, 張智釗, 盧家靈, 等. 改良第一趾蹼皮瓣游離移植術后供區創面的修復. 中國修復重建外科雜志, 2013, 27(10):1279-1280.
17. 徐達傳, 張世民, 唐茂林. 穿支皮瓣及相關術語的初步共識. 中華顯微外科雜志, 2011, 34(5):358-359.
18. 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.
19. Kimura N, Satoh K, Hosaka Y. Tensor fasciae latae perforator flap. Clin Plast Surg, 2003, 30(3):439-446.

Chinese Journal of Reparative and Reconstructive Surgery

FREE CROIN FLAP FOR REPAIRING DEFECTS OF DONOR AFTER TOE TISSUE TRANS PLANTATION

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