Repairing defect of fingertip with different types of free tissue perforator flaps based on superficial palmar branch of radial artery / 中华显微外科杂志

ABSTRACT

Objective:To explore the repair of fingertip defects with transplantation of different types of free perforator flaps pedicled with the superficial palmar branch of radial artery (SPBRA).Methods:A retrospective analysis was carried out of the clinical data of 46 fingers from 38 cases [28 males and 10 females, aged 17-54 years with a mean age at (38.5±15.5) years] with tissue defects of fingertips that were repaired with free perforator flaps based on SPBRA, between January, 2013 and December, 2018. The soft tissue defects were 1.5 cm ×3.5 cm to 2.5 cm×5.5 cm. Among them, 8 cases were repaired with bilateral free SPBRA perforator flaps. Thirteen flaps carried long palmar tendon. Thirty flaps carried radial nerve and the other 16 flaps without. The size of flaps was 1.6 cm×4.0 cm- 2.8 cm×6.0 cm. Donor sites were all closed directly. Monthly postoperative follow-up was conducted. All the evalua- tion indexes of flap were measured and recorded. Instructed patients to do wrist and finger joint exercises.Results:All 46 flaps survived. No vascular crisis happened and all skin grafts survived in donor sites. There was 0.5 cm×0.3 cm of distal flap necrosis in 1 case and healed by dress changing. Thirty-eight cases had followed-up for 6 to 24 months. The flaps were soft and elastic, and colours were near to normal. There was no bulkiness. Sensory function re- covered well and TPD was 5.0-8.5 mm. The function and appearance of the finger were good. According to the Oper- ative Hand Surgery Function Evaluation of Flap after 6 months, the result was excellent in 42 cases, good in 3 cases, fair in 1 case, with 97.83% of excellent and good rate.Conclusion:Using different types of free tissue perforator flap based on SPBRA can repair fingertip defect, and reconstruct the defect of digital artery, nerve or tendon in one stage. The operation was simple and easy to do, and can achieved good results with high survival rates and good function recovery.