title: [CLINICAL APPLICATION OF LATERAL ARM LOBULATED FLAPS TO REPAIR MULTIPLE SOFT TISSUE DEFECT OF HAND].
abstract: OBJECTIVE
  To explore the effectiveness and operation of repairing multiple soft tissue defects in hands with lateral arm lobulated flaps.
  
  
  METHODS
  Between October 2013 and September 2015, 13 cases of multiple soft tissue defects in the hand with tendon or bone exposure were treated with lateral arm lobulated flaps. All patients were males with average age of 28 years (range, 23-45 years). Defects were caused by penetrating injury in 7 cases, traffic accident injury in 3 cases, and hot-crush injury in 3 cases. Six patients had skin defect of the left 2 fingers after opening finger amputation, and 7 patients had skin defect of the palm and the back after hand injury. The size of skin defects ranged from 6 cm x 5 cm to 9 cm x 6 cm. All patients underwent emergency debridement and two-stage repair; the duration from injury to operation was 5-9 days (mean, 7 days). The size of flap was 6 cm x 5 cm-9 cm x 6 cm.
  
  
  RESULTS
  All flaps survived completely, with no vascular crisis. Primary healing was obtained at donor and recipient sites, and the grafted skin survived. All cases were followed up 3-24 months (mean, 12 months). The appearance and texture of the flaps were similar to those of adjacent skin. Bulky flap was observed in 4 cases, and second stage operation was performed to make the flap thinner at 3 months after operation. The sensation of flap reached S₃-S₄.
  
  
  CONCLUSIONS
  The lateral arm lobulated flap based on the radial collateral artery has constant vascular anatomy, easy-to-harvest, and large rotation angle. It is an effective procedure to repair small and medium size skin defects of the hand with satisfied texture and sensory recovery.
authors.forename: Shuming
authors.initials: S
authors.lastname: Ye
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Teng
authors.forename: Hong
authors.initials: H
authors.lastname: Chen
authors.forename: Juehua
authors.initials: J
authors.lastname: Jing
authors.forename: Jisen
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D003646:Debridement; D005542:Forearm / Q000601:surgery; D006085:Graft Survival; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012677:Sensation; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps; D013710:Tendons; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult