ABSTRACT
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.
ABSTRACT
Objective@#To explore the clinical application of the profunda artery perforator flap in breast reconstruction of patients with early-staged breast cancer.@*Methods@#Six cases of early breast cancer patients received radical or modified radicaI surgery.The PAP flap was used to reconstruct breast at the same time or in the second phase.Four cases of breast cancer were in stage I and 2 cases was in stage II.@*Results@#The length of flap was (25.2±0.2) cm, the width of flap was (6.4±0.8) cm, the thickness of flap was (2.6±0.2) cm. The length of pedicle was (7.2±0.6) cm, the outer diameter of pedicle was (1.6±0.3) mm.The average weight of flap was 345 g(ranged from 225 g to 575 g). All profunda artery perforator flaps were successful. In one flap fat necrosis occurred and healed with dressing treatment. The reconstructed breasts′ shape, texture and elasticity was good and no flap contracture deformation happened. Only linear scar left in the donor sites, the function of thighs was not affected. All 6 patients were followed up for 2-3 months (2.5 months on average) with satisfied result. No local recurrence happened.@*Conclusions@#PAP flap is suitable to reconstruct breast for breast cancer patients.