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1.
Chinese Journal of Plastic Surgery ; (6): 1000-1003, 2019.
Article in Chinese | WPRIM | ID: wpr-796697

ABSTRACT

Objective@#To introduce the design of modified Reading man flap, and observe the clinical effect of modified flap for repairing digit and toe wounds.@*Methods@#From July 2014 to September 2017, dorsal skin defects on 37 digits and 18 toes were repaired with our modified Reading man flaps. The revised design was characterized with enlargement the major flap and extending the minor flap proximally, and all donor site defect were sutured primarily through the major flap recover the defect and the minor flap repair the subsequent donor defect.@*Results@#All the detects in 55 patients were repaired by the modified Reading man flaps with direct donor sites closure. With average of 11.5 months (9.5-25.7 months) follow-up, all flaps survived with satisfactory texture and appearance, the bulky deformity and scar contracture did not occur. Partial necrosis of tip in the minor flaps occurred in 2 toes and healed by wound dressing. The function of the toe joints was good and the walking gait was normal. Partially impaired PIP joint function with limited flexion occurred in 2 cases. Based on the TAM evaluation criteria, the results were excellent in 28 digits, good in 7 digits, and the overall satisfactory rate was 94.6%.@*Conclusions@#The modified Reading man flap can get good clinical effects for treatment of the digit and toe dorsal skin defect with the advantages of simple procedure, easy transfer and direct closure of donor sites. Flaps appearance and joints function can get good result postoperatively.

2.
Chinese Journal of Microsurgery ; (6): 559-562, 2018.
Article in Chinese | WPRIM | ID: wpr-735011

ABSTRACT

Objective To explore the Reading man flap for the treatment of soft tissue defects in distal fin-gers. Methods From May, 2014 to June, 2017, Reading man flaps were transferred in the emergency room to repair soft tissue defects in distal fingers in 46 patients. There were 28 cases of finger pulp defects, 6 cases of dorsal defects and 12 cases of finger stump defects with the size of soft tissue defects ranged from 1.0 cm×0.9 cm to 2.2 cm×2.0 cm (average, 1.2 cm×1.3 cm).The volar, dorsal and hybrid flaps were 28, 6 and 12 cases respectively.The average size of the major flap and minor flap were 1.8 cm×1.2 cm and 1.4 cm×0.8 cm, respectively. All donor sites were sutured di-rectly.All patients were followed-up by review in the outpatient department. Results The consumed operative time was 35-48 min, with an average of 37.8 min. Prophylactic antibiotics and wound dressing were conducted postopera-tively. The tip of the minor flaps occurred inflammation and small blister in 2 cases and eased by removal of the tip sutures.Traumatic neuralgia occurred in 1 case and self-healed after 3 months.Twenty-six cases were followed-up at least 11 months, which were 16 cases of finger pulp defects, 3 of dorsal defects and 7 of finger stump defects. On an average of 10.5 (9-27) months followed-up, all flaps survived. Except 4 cases with slim hook nail deformity, the re-maining flaps were observed with satisfactory texture and appearance, the bulky deformity and scar contracture did not occur.Two points distinguishment on the major and minor flaps were 3.3-6.2 (average, 4.5)mm and 5.5-9.8(average, 7.1)mm respectively. According to the Trial Standard for Evaluation of Upper Limb Function of Chinese Society of Hand Surgery, it was excellent in 28 cases, good in 11 cases and moderate in 7 cases, with the overall excellent and good rate of 84.8%. Conclusion The Reading man flap is a good option for treatment of the small size soft tissu de-fect in distal fingers with the advantages of simple procedure, high success rate, good appearance and sensory recovery.

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