Comparison of therapeutic efficacy between venous flap and the flap with superficial palmar branch of radial artery in reconstruction of the defect of finger with segmental defect of proper digital artery / 中华显微外科杂志

ABSTRACT

Objective:To compare the effectiveness of venous flap and the flap based on superficial palmar branch of radial artery (SPBRA) in the reconstruction of the defect of finger with segmental defect of proper digital artery.Methods:From July, 2014 to March, 2018, 40 patients with soft tissue defects of finger and the proper arteries were treated by the venous flaps (18 cases, group A) and the flaps based on SPBRA (22 cases, group B). The operative time, postoperative 2-PD of the flaps, appearance, patient satisfaction, flaps donor site complications, flaps survival rate and the motion of digital joints were observed and compared by software SPSS 17.0. P<0.05 was considered statistically significant. Results:Forty flaps all survived, and the wounds healed primarily. The operative time of group A was (78.89±7.36) min, which was shorter than that of group B (97.27±9.26) min, with statistically significant difference ( P<0.05) between the two groups. At end of followed-up, there was a statistically significant difference in the 2-PD of the flaps between the 2 groups [(7.94±1.55) mm in group A, (6.59±1.65) mm in group B, P<0.05)]. The overall active motion of the digital joints 13 cases were excellent, and 5 cases were good in group A. And 17 cases were excellent, 5 cases were good in group B. The satisfactory was 100% in both groups. Of patient satisfactory, group A 4 cases were great satisfactory, 13 were satisfactory, and 1 was fair; Group B 17 cases were great satisfactory and 5 were satisfactory. The appearance of flaps in group A, 16 cases were good and 1 was bad, while in group B, 21 cases were good and 1 was bad. And there was no statistically significant difference between the 2 groups ( P>0.05). Conclusion:A higher survival rate and satisfactory clinical efficacy can be achieved by the venous flaps and the flap based on SPBRA while the area of defect in hand soft tissue, where there exists a segmental defect of proper arteries, is small. In terms of the recovery of sensing, the first choice is the flap based on SPBRA. In considering of the difficulty in surgical operation, the venous flap is a relatively simple procedure.