Reconstruction of Soft Tissue Defects in the Hand with a Free Anterolateral Thigh Deep Fascia Flap
| Autor: | Tiepeng Ma, Li Wang, Xueqiang Wu, Liu Zhang, Huiren Liu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Soft Tissue Injuries Visual analogue scale Free Tissue Flaps Dressing change Soft tissue defect Anterolateral thigh flap 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Fascia Deep fascia flap Pain Measurement Retrospective Studies Orthopedic surgery 030222 orthopedics Clinical Article Mild pain business.industry Soft tissue Hand Injuries Anterolateral thigh Middle Aged Plastic Surgery Procedures Hand Surgery Thigh Patient Satisfaction Clinical Articles Blood supply Female Deep fascia Reconstruction business RD701-811 030217 neurology & neurosurgery |
| Zdroj: | Orthopaedic Surgery Orthopaedic Surgery, Vol 13, Iss 3, Pp 758-767 (2021) |
| ISSN: | 1757-7861 1757-7853 |
| Popis: | Objective To report our experience in the reconstruction of soft tissue defects in the hand with a free anterolateral thigh deep fascia flap and describe the clinical outcomes. Methods This study was a retrospective trial. From November 2016 to January 2020, six patients (four men and two women) with soft tissue defects in the hand were included in this study. The average age of the patients was 33.7 ± 12.7 years (range, 20 to 50 years). All patients underwent reconstructions with free anterolateral thigh deep fascia flaps. Relevant clinical characteristics were recorded prior to surgery. The size and thickness of the deep fascia flap and the thickness of the skin were measured intraoperatively. The survival of the flaps and skin grafts and the occurrence of infection were recorded after the operation. At follow‐up, donor site complications and postoperative effects were evaluated according to the outcome satisfaction scale. The pain in the injured hand was assessed using the visual analog scale. Results The average body mass index (BMI) was 26.6 ± 1.7 kg/m2 (range, 23.9 to 28.7 kg/m2). The defect sizes ranged from 5 cm × 5 cm to 13 cm × 8 cm (average, 53.1 ± 27.9 cm2). The six anterolateral thigh deep fascia flaps ranged from 7 cm × 6 cm to 14 cm × 9 cm in size (average, 71.8 ± 29.1 cm2). The thicknesses of skin ranged from 25 mm to 40 mm (average, 32.5 ± 4.8 mm), and the thicknesses of the deep fascia flaps ranged from 2 mm to 3 mm (average, 2.5 ± 0.5 mm). After the operation, the blood supply of the deep fascia flap was normal in all cases. The second‐stage skin grafts of most patients survived completely. The skin graft in one case was partially necrotic and healed after a dressing change. No infection occurred. At follow‐up (average, 16.3 ± 6.9 months), there was only a linear scar and no loss of sensation at the donor site of each patient. According to the outcome satisfaction scale, the outcome satisfaction score ranged from 6 to 8 (average, 7.2 ± 0.9), all of which were satisfactory. Apart from one patient who reported mild pain, all the other patients reported no pain. Three typical cases are presented in this article. Conclusions The free anterolateral thigh deep fascia flap, which is suitable for reconstruction of soft tissue defects in the hand, can provide very good outcomes both functionally and aesthetically. We present a newly free anterolateral thigh deep fascia flap. The flap, which can avoid the bulky appearance of the traditional anterolateral thigh flap and involves fewer complications at the donor site, is suitable for the reconstruction of soft tissue defects in the hand, especially irregular defects in obese and/or female patients. It can provide good outcomes both functionally and aesthetically. |
| Databáze: | OpenAIRE |
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