title: [Effectiveness of improved interosseous dorsal artery reversed island flap for dorsal skin and soft tissue defect of hand].
abstract: OBJECTIVE
  To discuss the effectiveness of improved interosseous dorsal artery reversed island flap to repair dorsal skin and soft tissue defect of the hand.
  
  
  METHODS
  Between March 2009 and September 2012, 29 cases of dorsal skin and soft tissue defects were treated with improved interosseous dorsal artery reversed island flap. Of 29 cases, there were 17 males and 12 females, aged 23-71 years (mean, 47 years); and the left hand was involved in 12 cases and the right hand in 17 cases. There were 11 cases of avulsion injury, 9 cases of crushing injury, 5 cases of strangulation injury, and 2 cases of traffic accident injury; the interval of injury and admission was 1-7 hours (mean, 4 hours). Two patients had scar contracture. The locations of soft tissue defects were dorsal hands in 21 cases, first webs in 5 cases, and dorsal thumb in 3 cases. The size of soft tissue defects ranged from 4 cm x 3 cm to 10 cm x 8 cm. One-stage repair was performed in 11 cases, and two-stage repair in 18 cases. The size of flaps ranged from 5.5 cm x 4.5 cm to 12.0 cm x 10.0 cm. The donor sites were sutured directly or repaired by skin grafting.
  
  
  RESULTS
  All flaps survived, and wounds healed in first stage. And the grafted skins at donor sites all survived, and incisions all healed in first stage. Twenty-six patients were followed up 3 months-3 years (mean, 19.5 months). Bulky flap was observed in 3 cases, and defatted operation was performed after 6 months; the other flaps had good appearance and texture, and wrist function was normal. According to total angle of motion (TAM) systematic evaluation, the results were excellent in 17 cases, good in 6 cases, and fair in 3 cases at 3 months after operation.
  
  
  CONCLUSIONS
  Improved interosseous dorsal artery reversed island flap has the advantages of easy-to-obtain, simple operation, and high survival rate of flaps, so it is an effective method to repair dorsal skin and soft tissue defect of the hand.
authors.forename: Fanyu
authors.initials: F
authors.lastname: Bu
authors.forename: Mingyu
authors.initials: M
authors.lastname: Xue
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Rui
authors.forename: Liming
authors.initials: L
authors.lastname: Gu
authors.forename: Kuishui
authors.initials: K
authors.lastname: Shou
authors.forename: Li
authors.initials: L
authors.lastname: Qiang
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000601:surgery; D005260:Female; D005542:Forearm / Q000601:surgery; D006085:Graft Survival; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012867:Skin / Q000293:injuries; D016038:Skin Transplantation / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D013933:Thumb / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult