Application dorsalis pedis flap to repair the hands of series 2 of skin and soft tissue defect / 中华显微外科杂志

Objective To evaluate the clinical effects of free dorsalis pedis flap on the repair of two skin and soft tissue defects in hand. Methods From February 2003 to February 2009, free dorsalis pedis flap was used to repair two skin and soft tissue defects in 11 patients. Six cases were males and 5 females.Two was used the hand skin and soft tissue defects in 4 cases; back of the hand skin and soft tissue defect with the middle finger proximal palmar skin and soft tissue defect in 1 case, the hand ripped through injury to the back of the hand of the hand ripped through skin and soft tissue defects in 3 cases, were cut flap:proximal flap 3 cm× 3 cm-8 cm × 7 cm, distal flap 4 cm × 2 cm-6 cm × 5 cm. Foot for the area will adopt the lower abdominal full-thickness skin grafting. Results Uniform flap survival period of the wound healing class, foot skin graft donor sites were successfully survived. Ten patients were followed up from 6 to 19 months, with an average follow-up of 9 months. Follow-up flap fine texture, appearance of natural, nonbloated, feeling to restore S2-S3, hand function recovered satisfactorily, for the district of foot healed well without ulceration and ulcer formation,had no effect on walking function. Conclusion The dorsalis pedis flap for hand two series of skin and soft tissue defects, with design flexibility, excellent texture flaps, etc., is to repair the hand skin and soft tissue defects of the two better way.

Reconstruction of Thumb and Finger by Transplantation of Composite Toe Tissues: Experience in 208 Cases / 中华创伤杂志

Transplantation of composite toe tissues with microsurgical technic has boen performed in 208 patients since Oct. 1979. Among the 242 digits reconstructed, 238 digits (204 patients) were successfully reconstructed and other four digits (4 patitents) failed. The success rate was 98.3%. In this series, 135 cases were loss of thumb, 28 cases loss of fingers, and 45 cases loss of both thumb and fingers. The reconstruction procedures were composed of thumb reconstruction in 166 cases (168 thumbs), finger reconstruction in 28 cases (42 fingers) and both thumb and finger reconstruction in 14 cases (32 digits). The transplantation of second toe were performed in 188 cases and nail-skin flap of great toe transplantation were used in 18 cases. Gilbert Ⅲ variation of the first dorsal metatarsal artery was encountered in 34 donor feet in 30 patients. All these cases were successfully operated upon. A new classification system of thumb loss is proposed. The indication of various operative procedures, different ways of vascular anastomosis, the choice of emergency reconstruction, the use of graft of toe extended with dorsalis pedis flap and the pitfalls of the operation were discussed in detail.