Consecutive flap transfer for repairing massive soft tissue defects in the opisthenar with improved donor site closure

• Published in: Chinese journal of traumatology Vol. 17; no. 5; pp. 256 - 260
• Main Authors: Lehao, Wu, Shan, Zhu, Mengqing, Zang, Dedi, Tong, Guanglei, Tian, Shanlin, Chen
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01.10.2014; Division of Plastic and Reconstructive Surgery, Tongji Hospital, Huazhong University of Science and Technology,Wuhan 430030, China%Department of Hand Surgery, Jishuitan Hospital, Peking University, Beijing 100035, China%Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730,China; Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730,China; Department of Hand Surgery, Jishuitan Hospital, Peking University, Beijing 100035, China; Elsevier
• Subjects: Adult; Arm Injuries - surgery; Debridement; Drainage; Female; Free scapular flap; Hand Injuries - surgery; Humans; Male; Perforator flap; Reconstructive Surgical Procedures - methods; Scapula - blood supply; Soft tissue defect; Soft Tissue Injuries - surgery; Surgical Flaps - blood supply; Treatment Outcome; 修复; 封闭; 流量不足; 皮瓣; 组织缺损; 转移支付; 软组织损伤; 面积; Perforator flap; Free scapular flap; Soft tissue defect
• ISSN: 1008-1275
• DOI: 10.3760/cma.j.issn.1008-1275.2014.05.002

Objective：To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site morbidity.Methods：Six patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular flaps.Afterwards,a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct closure.Results：All six free scapular flaps survived without signs of infection.Three adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex,which resolved after six weeks with only conservative therapy.All the incisions healed without other complications.At six-month follow-up,the patients regained full shoulder function.Conclusion：With the assistance of an adjacent pedicled flap,the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the opisthenar.It can achieve positive outcomes in both reconstructive and aesthetic aspects.