[Study on the effect of pedicle skin flap of subdermal vascular plexus on repairing the hand injury].
OBJECTIVE
To summarize the operation opportunity and recovery effect of pedicle skin flap of subdermal vascular plexus on repairing the raw surface of hand injury.


METHODS
From January 1999 to June 2004, the thoracic or abdominal pedicle skin flap of subdermal vascular plexus was used to repair the raw surface of hand with defect of skin and soft tissue in 22 patients with hand injury. 17 cases were males, 5 cases were females, the ages ranged from 9 to 42. The causes of hand injury including avulsed wound in 12 cases, mangled injury in 2 cases, hot crush injury in 5 cases, electric burn in 3 cases; 13 cases needed emergency operation, 9 cases needed operation in 3 to 7 days. The thoracic or lower abdominal flap was selected depending on the raw surface of hand injury. Subcutaneous fat was trimmed and retained the thickness of 2 to 4 mm. The skin flap was designed into 2 to 3 leaves to form several pedicle skin flap of subdermal vascular plexus, which were used to repair defect of skin and soft tissue of several fingers. The defect site of skin and soft tissue of hand were put into flap.


RESULTS
A little of skin flap in distal end became necrosis in 1 case after operation, but recovered fully after changing dressing to the raw surface. The rest of the flaps all survived. Follow-up was conducted 3 months to 2 years. The pedicle skin flap was living,the skin of the recipient site was smooth and integrated, color and luster was satisfactory and texture was soft. The disrupted pedicle skin flap needed no trimming. The hand function was significantly recovered.


CONCLUSIONS
To repair the defect of skin and soft tissue in the hand injury by using thoracic or lower abdominal pedicle skin flap of subdermal vascular plexus has the forte of shorter course of treatment and better functional recovery and good outlook. It is one of the ideals for repairing the hand injury with defect of skin and soft tissue.
Lin
Wenhai
W
Surgery, Shantou Center Hospital, Shantou Guangdong, 515031, P. R. China. lthlth8682@tom.com
Zheng
Tingzhong
T
Wang
Qingsheng
Q
D000293:Adolescent; D000328:Adult; D002648:Child; D020405:Dermis / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012867:Skin / Q000098:blood supply / Q000293:injuries; D016038:Skin Transplantation / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult