Repair of limb wounds with free profunda artery perforator flap in posteromedial femoral region_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LIU Yujie , DING Xiaoheng , JIAO Hongsheng , REN Shengquan , WANG Zhengdan

The Hand Surgery Center of PLA, the 971th Hospital of Chinese PLA, Qingdao Shandong, 266071, P.R.China;

Corresponding?author：

LIU Yujie, Email: liuyj2046@126.com

Keywords：

Profunda artery perforator flap; extremity wound; repair

DOI：

10.7507/1002-1892.201901069

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the effectiveness of free profounda artery perforator flap (PAPF) in the posteromedial femoral region for the treatment of traumatic skin defects of limbs.Methods Between March 2015 and April 2017, 11 cases of traumatic limb skin defect with deep tissue exposure were treated with free PAPF in posteromedial femoral region. There were 7 males and 4 females, with an average age of 39 years (range, 26-54 years). There were 4 cases of upper limb skin defect and 7 cases of lower limb skin defect. The causes of injury included 6 cases of traffic accident injury, 3 cases of machine crush injury, and 2 cases of crush injury. The size of wounds ranged from 11 cm×7 cm to 18 cm×11 cm. The time from post-traumatic admission to flap repair were 4-9 days (mean, 7.3 days). The size of free PAPF ranged from 15 cm×9 cm to 22 cm×13 cm. The donor site of 8 cases were closed directly; 3 cases could not be closed directly, and skin grafting was used to cover the wound.Results The time of skin flap harvest was 40-90 minutes (mean, 47 minutes). All flaps and skin grafts survived and the wounds healed by first intention. All the 11 patients were followed up 6-19 months (mean, 12 months). The skin flaps were soft in texture, similar in color to the skin around the injured limbs, without obvious pigmentation and hair overgrowth. Three of them underwent second-stage skin flap thinning. At last follow-up, the limb function of all patients recovered well. Longitudinal scar could be seen in the donor site of the flap, and the location was concealed. All patients did not complain that scar of the donor site affected their sexual life during the follow-up.Conclusion Free PAPF can achieve satisfactory results in repairing skin defects of extremities. The flaps have the advantages including constant perforator branches, simple operation, and concealed donor site.

Citation： LIU Yujie, DING Xiaoheng, JIAO Hongsheng, REN Shengquan, WANG Zhengdan. Repair of limb wounds with free profunda artery perforator flap in posteromedial femoral region. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(5): 590-594. doi: 10.7507/1002-1892.201901069 Copy

1.	Allen RJ, Haddock NT, Ahn CY, et al. Breast reconstruction with the profunda artery perforator flap. Plast Reconstr Surg, 2012, 129(1): 16e-23e.
2.	宋達疆, 李贊, 周曉, 等. 不同形式游離股深動脈蒂嵌合穿支肌皮瓣修復舌癌術后缺損的療效觀察. 中國修復重建外科雜志, 2017, 31(6): 696-701.
3.	Teotia SS, Cho MJ, Haddock NT. Salvaging breast reconstruction: profunda artery perforator flaps using thoracodorsal vessels. Plast Reconstr Surg Glob Open, 2018, 6(9): e1837.
4.	卿黎明, 賀繼強, 唐舉玉, 等. 基于活體造影數據的股深動脈穿動脈穿支血管的數字解剖學研究. 中國臨床解剖學雜志, 2016, 34(1): 12-15.
5.	DeLong MR, Hughes DB, Bond JE, et al. A detailed evaluation of the anatomical variations of the profunda artery perforator flap using computed tomographic angiograms. Plast Reconstr Surg, 2014, 134(2): 186e-192e.
6.	Angrigiani C, Grilli D, Thorne CH. The adductor flap: a new method for transferring posterior and medial thigh skin. Plast Reconstr Surg, 2001, 107(7): 1725-1731.
7.	賀繼強. 股深動脈穿動脈穿支皮瓣的解剖及臨床應用進展. 中國臨床解剖學雜志, 2017, 35(4): 475-477.
8.	劉溫悅, 穆蘭花, 張寒, 等. 股深動脈穿支皮瓣應用于乳房再造的解剖學研究. 中國臨床解剖學雜志, 2014, 32(4): 384-386.
9.	Mohan AT, Zhu L, Sur YJ, et al. Application of posterior thigh three-dimensional profunda artery perforator perforasomes in refining next-generation flap designs: transverse, vertical, and S-shaped profunda artery perforator flaps. Plast Reconstr Surg, 2017, 139(4): 834e-845e.
10.	Wu JC, Huang JJ, Tsao CK, et al. Comparison of posteromedial thigh profunda artery perforator flap and anterolateral thigh perforator flap for head and neck reconstruction. Plast Reconstr Surg, 2016, 137(1): 257-266.
11.	王劍利, 王根, 趙剛, 等. 游離股后側穿支動脈皮瓣的解剖學研究及臨床應用. 中華顯微外科雜志, 2013, 36(1): 7-10.
12.	穆籣, 彭喆, 畢曄, 等. 雙側游離股深動脈穿支皮瓣即刻乳房再造一例報告并文獻復習. 中華顯微外科雜志, 2016, 39(6): 555-558.
13.	Saad A, Sadeghi A, Allen RJ. The anatomic basis of the profunda femoris artery perforator flap: a new option for autologous breast reconstruction—a cadaveric and computer tomography angiogram study. J Reconstr Microsurg, 2012, 28(6): 381-386.
14.	Hunsinger V, Lhuaire M, Haddad K, et al. Medium- and large-sized autologous breast reconstruction using a fleur-de-lys profunda femoris artery perforator flap design: a report comparing results with the horizontal profunda femoris artery perforator flap. J Reconstr Microsurg, 2019, 35(1): 8-14.
15.	Haddock NT, Greaney P, Otterburn D, et al. Predicting perforator location on preoperative imaging for the profunda artery perforator flap. Microsurgery, 2012, 32(7): 507-511.
16.	宋達疆, 李贊, 周曉, 等. 股前內側接力穿支皮瓣修復游離股前外側穿支皮瓣供區的臨床應用. 中國修復重建外科雜志, 2017, 31(1): 52-56.
17.	Rozen WM, Donahoe S, Wilson JL. The profunda femoris artery " fourth perforator” island flap: a new perforator flap in lower-limb reconstruction. J Reconstr Microsurg, 2011, 27(4): 273-276.
18.	Ahmadzadeh R, Bergeron L, Tang M, et al. The posterior thigh perforator flap or profunda femoris artery perforator flap. Plast Reconstr Surg, 2007, 119(1): 194-202.

1. Allen RJ, Haddock NT, Ahn CY, et al. Breast reconstruction with the profunda artery perforator flap. Plast Reconstr Surg, 2012, 129(1): 16e-23e.
2. 宋達疆, 李贊, 周曉, 等. 不同形式游離股深動脈蒂嵌合穿支肌皮瓣修復舌癌術后缺損的療效觀察. 中國修復重建外科雜志, 2017, 31(6): 696-701.
3. Teotia SS, Cho MJ, Haddock NT. Salvaging breast reconstruction: profunda artery perforator flaps using thoracodorsal vessels. Plast Reconstr Surg Glob Open, 2018, 6(9): e1837.
4. 卿黎明, 賀繼強, 唐舉玉, 等. 基于活體造影數據的股深動脈穿動脈穿支血管的數字解剖學研究. 中國臨床解剖學雜志, 2016, 34(1): 12-15.
5. DeLong MR, Hughes DB, Bond JE, et al. A detailed evaluation of the anatomical variations of the profunda artery perforator flap using computed tomographic angiograms. Plast Reconstr Surg, 2014, 134(2): 186e-192e.
6. Angrigiani C, Grilli D, Thorne CH. The adductor flap: a new method for transferring posterior and medial thigh skin. Plast Reconstr Surg, 2001, 107(7): 1725-1731.
7. 賀繼強. 股深動脈穿動脈穿支皮瓣的解剖及臨床應用進展. 中國臨床解剖學雜志, 2017, 35(4): 475-477.
8. 劉溫悅, 穆蘭花, 張寒, 等. 股深動脈穿支皮瓣應用于乳房再造的解剖學研究. 中國臨床解剖學雜志, 2014, 32(4): 384-386.
9. Mohan AT, Zhu L, Sur YJ, et al. Application of posterior thigh three-dimensional profunda artery perforator perforasomes in refining next-generation flap designs: transverse, vertical, and S-shaped profunda artery perforator flaps. Plast Reconstr Surg, 2017, 139(4): 834e-845e.
10. Wu JC, Huang JJ, Tsao CK, et al. Comparison of posteromedial thigh profunda artery perforator flap and anterolateral thigh perforator flap for head and neck reconstruction. Plast Reconstr Surg, 2016, 137(1): 257-266.
11. 王劍利, 王根, 趙剛, 等. 游離股后側穿支動脈皮瓣的解剖學研究及臨床應用. 中華顯微外科雜志, 2013, 36(1): 7-10.
12. 穆籣, 彭喆, 畢曄, 等. 雙側游離股深動脈穿支皮瓣即刻乳房再造一例報告并文獻復習. 中華顯微外科雜志, 2016, 39(6): 555-558.
13. Saad A, Sadeghi A, Allen RJ. The anatomic basis of the profunda femoris artery perforator flap: a new option for autologous breast reconstruction—a cadaveric and computer tomography angiogram study. J Reconstr Microsurg, 2012, 28(6): 381-386.
14. Hunsinger V, Lhuaire M, Haddad K, et al. Medium- and large-sized autologous breast reconstruction using a fleur-de-lys profunda femoris artery perforator flap design: a report comparing results with the horizontal profunda femoris artery perforator flap. J Reconstr Microsurg, 2019, 35(1): 8-14.
15. Haddock NT, Greaney P, Otterburn D, et al. Predicting perforator location on preoperative imaging for the profunda artery perforator flap. Microsurgery, 2012, 32(7): 507-511.
16. 宋達疆, 李贊, 周曉, 等. 股前內側接力穿支皮瓣修復游離股前外側穿支皮瓣供區的臨床應用. 中國修復重建外科雜志, 2017, 31(1): 52-56.
17. Rozen WM, Donahoe S, Wilson JL. The profunda femoris artery " fourth perforator” island flap: a new perforator flap in lower-limb reconstruction. J Reconstr Microsurg, 2011, 27(4): 273-276.
18. Ahmadzadeh R, Bergeron L, Tang M, et al. The posterior thigh perforator flap or profunda femoris artery perforator flap. Plast Reconstr Surg, 2007, 119(1): 194-202.

Chinese Journal of Reparative and Reconstructive Surgery

Repair of limb wounds with free profunda artery perforator flap in posteromedial femoral region

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content