The clinical application of anterolateral thigh perforator flap with snuffbox cutaneous branch of the radial artery as recipient vessels for repair of dorsal hand wounds in children

Abstract

Objective To analyze the clinical efficacy of anterolateral thigh perforator flap with snuffbox cutaneous branch of the radial artery as recipient vessels for repair of dorsal hand wounds in children. Methods From January 2014 to January 2019, 7 cases of children with skin and soft tissue defects on the dorsum of hand ware covered by anterolateral thigh perforator flap with snuffbox cutaneous branch of the radial artery as recipient vessels by preoperative color Doppler ultrasound. The area of the flaps ranged from 4 cm×6 cm to 5 cm×7 cm. The donor sites were sutured directly. Results There were no infection, vascular crisis and necrosis of skin flaps after operation. All the children were follow-up for 6 to 42 months, with an average of 23.5 months. The skin flaps had satisfactory shape, soft texture, moderate thickness, good elasticity, good sweating function, partial superficial sensation recovery, good thumb web function and no complications such as thumb web skin contracture. Five children underwent liposuction at 5 months after operation. Mild scar hyperplasia of donor sites occurred in 4 cases. Conclusion The anterolateral thigh perforator flap with snuffbox cutaneous branch of the radial artery as recipient vessels is safe and effective in repairing the dorsal hand wound in children. It can shorten the time of skin flap removal, reduce the injury of donor site and not sacrifice the dorsal metacarpal branch of the radial artery. It is suitable for clinical promotion. Key words: Hand injuries; Surgical flaps; Repair; Microsurgery