One-stage reconstruction of complex soft tissue defects in the hands using multidigit, chimeric, lateral arm, perforator flaps. 2019

Shu-Ming Ye, and Yue Yu, and Jue-Hua Jing, and Yun Zhou, and Ji-Sen Zhang, and Xiao-Feng Teng, and Chun-Gui Xu, and Wen-Dan Cheng, and Zi-Yu Li, and You-Jia Xu
Department of Orthopaedics Surgery, the Second Affiliated Hospital of Soochow University, SuZhou, 235131, Jiangsu, China; Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.

OBJECTIVE To describe our experience using microsurgically fabricated, multilobed, chimeric, lateral arm (LA) flaps to reconstruct hand injuries with complex, multidigit, soft tissue defects and to evaluate the morbidity and esthetic and functional outcomes of the donor sites. METHODS We performed a single center, retrospective analysis of 21 patients with hand wounds treated from October 2013 to February 2016. All patients underwent reconstruction using multilobed, chimeric, free, LA flaps. A self-reported questionnaire was used to assess donor site morbidity and satisfaction with the esthetic and overall functional result. Outcome measures were the Disabilities of the Arm, Shoulder and Hand (DASH) score, static 2-point discrimination score, and visual analogue scale. RESULTS The study included 21 patients (20 males and 1 female), with an average age of 32.14 years (range 18-45 years), who sustained traumatic injuries in road traffic accidents (n = 2) or industrial devices (n = 19). The average DASH score was 28.25 ± 2.3, the average 2-PD score was 7.20 ± 1.30, and the average visual analogue scale (VAS) was 0.38 ± 0.40. All 21 patients had sensory disorders at the donor site. Postoperative donor site complications comprised wound dehiscence (n = 1) and hematoma (n = 3). The patient-rated satisfaction score for the donor site was 5.40 ± 0.90, and 70% of the patients would undergo the same surgery again. CONCLUSIONS Microsurgical fabrication of multilobed, chimeric, LA flaps can exhibit sensory recovery and minimal pain but may cause hematoma and sensory disorders at the donor site. The flaps are a viable alternative for the reconstruction of complex, multidigit, soft tissue defects of the hands.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D005260 Female Females
D005385 Fingers Four or five slender jointed digits in humans and primates, attached to each HAND. Finger
D006230 Hand Injuries General or unspecified injuries to the hand. Injuries, Hand,Hand Injury,Injury, Hand
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D015599 Trauma Severity Indices Systems for assessing, classifying, and coding injuries. These systems are used in medical records, surveillance systems, and state and national registries to aid in the collection and reporting of trauma. Trauma Severity Index,Trauma Severity Indexes,Index, Trauma Severity,Indexes, Trauma Severity,Indices, Trauma Severity,Severity Index, Trauma,Severity Indexes, Trauma,Severity Indices, Trauma
D017060 Patient Satisfaction The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. Satisfaction, Patient

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