Customized reconstruction of complex soft tissue defects in the upper extremities with variants of double skin paddle anterolateral thigh perforator flap.


Journal

Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 29 11 2020
revised: 22 04 2021
accepted: 25 04 2021
pubmed: 18 5 2021
medline: 23 6 2021
entrez: 17 5 2021
Statut: ppublish

Résumé

Complex soft tissue defects in the upper extremities are challenging to reconstruct. The purpose of this study was to share our experience with using four variants of double skin paddle Anterolateral Thigh Perforator (ALT) flap to achieve the customized reconstruction of the complex defects. From January 2007 to December 2019, 15 patients (14 male and 1 female) aged 15-61 years underwent double skin paddle ALT flap reconstruction of the upper extremities. 10 wounds were located in the wrist or hand, while four wounds were located in the forearm, and one wound in the elbow. All the wounds were large with non-adjacent defects and with or without a dead space. Four variants of double skin paddle anterolateral thigh perforator flaps were harvested according to the patient's needs. The flaps received were consisted of 7 classic double skin paddle ALT flap, 4 vastus lateralis muscle-chimeric double skin paddle ALT flap, 2 microdissected thin double skin paddle ALT flap, and 2 flow-through double skin paddle ALT flap. The size of the skin flap ranged from 6 × 6 cm Variants of double skin paddle ALT flaps provide versatile design and allow customized reconstruction of complex soft tissue defects in the upper extremities with limited donor site morbidity. We believe that the algorithm provided will help the surgeons with deciding among variants of double skin paddle ALT flap.

Sections du résumé

BACKGROUND BACKGROUND
Complex soft tissue defects in the upper extremities are challenging to reconstruct. The purpose of this study was to share our experience with using four variants of double skin paddle Anterolateral Thigh Perforator (ALT) flap to achieve the customized reconstruction of the complex defects.
PATIENTS AND METHODS METHODS
From January 2007 to December 2019, 15 patients (14 male and 1 female) aged 15-61 years underwent double skin paddle ALT flap reconstruction of the upper extremities. 10 wounds were located in the wrist or hand, while four wounds were located in the forearm, and one wound in the elbow. All the wounds were large with non-adjacent defects and with or without a dead space. Four variants of double skin paddle anterolateral thigh perforator flaps were harvested according to the patient's needs.
RESULTS RESULTS
The flaps received were consisted of 7 classic double skin paddle ALT flap, 4 vastus lateralis muscle-chimeric double skin paddle ALT flap, 2 microdissected thin double skin paddle ALT flap, and 2 flow-through double skin paddle ALT flap. The size of the skin flap ranged from 6 × 6 cm
CONCLUSIONS CONCLUSIONS
Variants of double skin paddle ALT flaps provide versatile design and allow customized reconstruction of complex soft tissue defects in the upper extremities with limited donor site morbidity. We believe that the algorithm provided will help the surgeons with deciding among variants of double skin paddle ALT flap.

Identifiants

pubmed: 33994191
pii: S0020-1383(21)00415-0
doi: 10.1016/j.injury.2021.04.067
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1771-1777

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no conflict of interests. The authors alone are responsible for the content and writing of the paper.

Auteurs

Jiqiang He (J)

Department of Hand & Microsurgery, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, Hunan Province, China; Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

Liming Qing (L)

Department of Hand & Microsurgery, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, Hunan Province, China.

Panfeng Wu (P)

Department of Hand & Microsurgery, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, Hunan Province, China.

Zhengbing Zhou (Z)

Department of Hand & Microsurgery, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, Hunan Province, China.

Fang Yu (F)

Department of Hand & Microsurgery, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, Hunan Province, China.

Xing Zhang (X)

Department of Hand & Microsurgery, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, Hunan Province, China.

Juyu Tang (J)

Department of Hand & Microsurgery, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, Hunan Province, China. Electronic address: tangjuyu@csu.edu.cn.

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