[Thoracodorsal artery perforator pedicled flap for repair of soft tissue defects on the ipsilateral upper limb: a report of 8 cases].

OBJECTIVE: To summarize clinical application result of the thoracodorsal artery perforator pedicled flap for repair of soft tissue defects on the ipsilateral upper limb. METHODS: From September 2003 to May 2007, 8 patients (6 males and 2 females) with soft tissue defects on the ipsilateral upper limb underwent reconstruction with the thoracodorsal artery perforator pedicled flap. The age of patients was from 16- to 45-years-old with an average of 32 years. Of them, the recipient sites of 5 cases were located on the arm region, 3 cases on the forearm. RESULTS: The minor superficial infection of 1 case occurred on the recipient site after operation and the wound gradually healed by daily change dressings. All the flaps had survived completely and the postoperative course was uneventful with satisfactory clinical results. Follow-up period ranged for 9-38 months after operation (mean, 19 months). There was no remarkable donor site morbidity. All cases had good appearance on recipient site. CONCLUSION: The thoracodorsal artery perforator pedicled flap is thin and suitable for repair of soft tissue defect on the ipsilateral upper limb.

[The sural medial gastrocnemius island muscle flap to cover wound of infection on upper region of the tibial].

OBJECTIVE: To summarize clinical application of the sural medial gastrocnemius island muscle flap to cover wound of infection on upper region of the tibial. METHODS: Nine patients (7 men, 2 women) with soft tissue defects on the upper region of the tibial underwent reconstruction with the sural medial gastrocnemius island muscle flap. The age ranged from 21 to 60 years old (mean, 34 years). The immediate coverage of the muscle flaps were performed by a meshed split-thickness skin graft. The donor site was closed directly. The donor leg was ipsilateral in all cases. RESULTS: Only one case sustained superficial infection postoperative and the gradual wound healed by daily wound dressings. All the muscle flaps and skin graft had survived completely without major complication with satisfactory clinical results. All patients were followed-up for 13 months to 4 years (mean 21 months), the donor site was healing, there was no remarkable donor site morbidity. CONCLUSION: The sural medial gastrocnemius island muscle flap is nourished by the medial sural artery. The muscle flaps seem to have highly vascularize, a constant vascular anatomy and a long vascular pedicle. The muscle flap is thin and suitable for repairing soft tissue defect on the upper region of the tibial.

Prefabricated flap to repair heel defect of child.

The coverage of large soft tissue defects in heel is a problem for surgical reconstruction. Various reconstructive materials are available depending on the location, size and depth of heel defect, but unique function of heel skin cannot be restored easily by means of reconstruction. We used prefabricated flap of the foot heel to cover heel defect in a child and obtained satisfactory clinical results.

[Reconstruction of distal phalanx defect with microsurgical fascia latae flaps combined with rib and skin graft].

OBJECTIVE: To evaluate the clinical application of microsurgical fascia latae flaps combined with rib and skin graft for reconstruction of the distal phalanx defect. METHODS: The phalanx wounds were sutured together like syndactyly. The autologous rib was revised to repair the bone defect of distal phalanx. The fascia latae flap was used to cover the bone exposure with microvascular anastomoses and resurfaced by a meshed split-thickness skin graft. RESULTS: 5 cases were treated successfully. The fascia latae flaps were all survived with only skin graft necrosis at the distal end in one case. It was healed spontaneously. CONCLUSIONS: The fascia latae flap is nourished by the descending branch of the lateral circumflex femoral artery. The flaps has a good blood supply and can be easily obtained with a long vascular pedicle. The flap is ideal for the reconstruction of distal phalanx defect when combined with autologous rib implant and skin graft.