Clinical application of free perforator hypothenar flap for thumb pulp defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To summarize the therapeutic effect of free perforator hypothenar flap for thumb pulp defect.</p><p><b>METHODS</b>From Jun. 2012 to Mar. 2013,8 cases with thumb pulp defect accompanied with exposure of phalanges ans tendons were treated by free ipsilateral perforator hypothenar flap. The flaps were 1.4 cm x 2.0 cm-1.8 cm x 2.2 cm in size. Ulnar finger artery in the flap was anastomosed with thumb artery. The accompanied veins and superficial veins were respectively anastomosed with thumb dorsal veins. Nerve branches in flaps were sutured with unilateral finger nerve to reconstruct flap feeling with 9-0 thread. Wounds in the hypothenar donor site were sutured directly.</p><p><b>RESULTS</b>All the flaps survived completely with primary healing both in donor and recipient area. 8 cases (8 fingers) were followed up for 6-13 months (average 9 months). The flaps appearance, texture were good. The two-point discrimination distance on flap was 7-10 mm. The active and passive movement of thumb joints was normal. There was no complain about the feeling at the donor site. Linear scar was left on the donor site. Patients hand grip strength was not decreased.</p><p><b>CONCLUSIONS</b>The free perforator hypothenar flap which has constant vascular anatomy is a new method for thumb soft tissue defect with less morbidity to donor site. The operative procedures are relatively simple.</p>

Reconstruction of small skin defect on children heel with V-Y advanced flap pedicled with perforator of peroneal artery at posterior lateral malleolus / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of V-Y advanced flap pedicled with perforator of peroneal artery at posterior lateral malleolus for small skin defect on children heel.</p><p><b>METHODS</b>From Mar. 2012 to Jan. 2014, 9 children with small skin defects on heel were treated with adjacent V-Y advanced flap pedicled with perforator of peroneal artery at posterior lateral malleolus. The flaps were 8.0 cm x 4.0 cm to 9.0 cm x 4.5 cm in size and the wounds at donor sits were directly closed.</p><p><b>RESULTS</b>All flaps survived completely with primary healing. 9 cases were followed up for 6-12 months( average, 9 months). The flaps had good match with surrounding tissue in texture and color. The function of ankle was normal. All the parents were satisfied with functional and cosmetic results.</p><p><b>CONCLUSIONS</b>It is a safe and practical method for treatment of small skin defect on children heel with adjacent V-Y advanced flap pedicled with perforator of peroneal artery at posterior lateral malleolus.</p>

Reconstruction of soft tissue defects at finger tip with relay flaps pedicled by perforator from digital artery / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the application of relay flaps pedicled by perforator from digital artery for reconstruction of soft tissue defects at finger tip.</p><p><b>METHODS</b>From Mar. 2012 to Jun. 2014, 9 cases with soft tissue defects at finger tip were reconstructed with relay flaps at one side of finger pedicled by perforator from digital artery. The flap size ranged from 1.3 cm x 1.6 cm to 1.6 cm x 2.2 cm. The defects at donor sites were covered by adjacent web perforator V-Y advanced flaps.</p><p><b>RESULTS</b>All the 18 flaps in 9 cases survived completely with primary healing both in recipient and donor sites. The patients were followed up for 5 months to 2 years ( average, 12 months) with good elasticity and cosmetic results. No pain happened in the treated finger. The 2-point discrimination distance was 7-8 mm in fingertip flaps, and 10-12 mm in web perforator flaps. Hand function was graded as excellent in 7 cases, good in 2 cases, based on ATM assessment. The affected fingers had normal temperature and cold-resistance during winter. The width and depth of web in the donor site were not affected.</p><p><b>CONCLUSIONS</b>The relay flaps pedicled by perforator from digital artery can be applied for reconstruction of soft tissue defects at finger tip. The procedure is easy with satisfactory results and reservation of main artery. No skin graft is necessary for closure of defects on donor sites.</p>