Use of a perforator-based flap from the ulnar palmar artery for the repair of defects caused by the treatment of severe contractures due to Dupuytren's disease.
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Abstract
Objective: The aim of this study was to investigate the clinical effectiveness of a perforator flap from the ulnar palm in repairing soft tissue defects in the palm and fifth digit following severe Dupuytren's contracture.
Methods: A retrospective study was conducted between March 2013 and January 2023. In total, 25 patients with soft tissue defects that occurred after severe Dupuytren's contracture release were treated using a perforator flap from the ulnar palm. Improvements in symptoms and functionality were assessed and compared before and after surgery. Data regarding the degree of contracture, two-point discrimination, and the total active motion (TAM) scale of the affected hand were collected by the same physician at the specified time points (preoperative, postoperative, and final follow-up), along with an evaluation of the donor and recipient areas of the flap. Concurrently, patients completed the visual analog scale (VAS) and disability of arm, shoulder, and hand (DASH) questionnaires.
Results: All 25 flaps survived uneventfully, and the wound healed primarily. The follow-up time was 15-26 months (average, 20.48 months). At the final follow-up, the patient satisfaction score related to flap appearance ranged from 4 to 5 (mean, 4.72). The average two-point discrimination value of the flap was 5.52 ± 0.97 mm. The contracture of the affected hand was improved with a mean TAM of 229° ± 16.75°. Furthermore, the degree of pain and functional status of the affected hand had improved (P < 0.05).
Conclusion: A perforator flap from the ulnar palm is a good option to repair the wound that occurs after severe Dupuytren's contracture release.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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