[Repair of large skin defect of forearm and hand using bilateral groin flaps and abdominal flaps].
OBJECTIVE
To investigate an operative method of repairing large skin defect of the forearm and the hand.


METHODS
From July 2003 to September 2008, 11 patients with large skin defect of the forearm and the hand were repaired using bilateral groin flaps in complex with abdominal flaps, including 7 males and 4 females aged 17-55 years old (average 33.5 years old). Among the 11 cases, 5 were caused by carding machine and 4 by traffic accident, and the interval between injury and operation was 90 minutes to 6 hours (average 3.5 hours); 2 cases suffered from severe cicatricial contracture deformity in the late stage of burn injury, and the interval between injury and operation was 7 months and 19 months, respectively. The size of skin defect ranged from 42 cm x 12 cm to 60 cm x 16 cm. The flaps harvested during operation was 45.0 cm x 10.5 cm - 62.0 cm x 18.0 cm in size. Pedicle division of the combined flaps was performed 4 weeks after operation. The donor site wound was repaired by direct suturing in 7 cases and by free skin grafting in 4 cases.


RESULTS
All flaps survived. All incisions healed by first intention. The donor site wound all healed by first intention. Skin graft all survived. All patients were followed up for 2 months to 3 years. The flaps were soft in texture, full in contour, and normal in color. Sensory recovery of the flaps was evaluated according to the Criteria of UK Medical Research Council (1954), 4 cases were in grade S1, 6 in grade S2, and 1 in grade S3. Hand function was assessed by the Criteria of Chinese Hand Surgery Society, 7 cases were graded as excellent, 2 as good, 2 as poor, and the excellent and good rate was 81.8%.


CONCLUSIONS
Combined use of bilateral groin flaps and abdominal flap is an effective approach to repair large skin defect of the forearm and the hand due to its simple operative procedure and satisfying effect.
Gong
Zhixin
Z
Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang Hebei 050051, PR China. gzx5678@sina.com
Tian
Dehu
D
Zhang
Jingqi
J
Zhang
Guisheng
G
Zhang
Bing
B
Wang
Shihui
S
Liu
Jianmin
J
D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D005260:Female; D005543:Forearm Injuries / Q000601:surgery*; D006119:Groin / Q000601:surgery; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012867:Skin / Q000293:injuries; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D055815:Young Adult