Combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery for the reconstruction of large area tissue defects of upper limbs

Objective To explore the feasibility and clinical efficacy of combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery for the reconstruction of large area tissue defects of upper limbs. Methods From January 2014 to June 2018, 22 patients with large area skin and soft tissue defects of upper extremities were treated with bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery. The donor site was closed directly. The wound involved upper arm, forearm, hand and elbow stump. The area of defect ranged from 16 cm×13 cm to 40 cm×15 cm. Results Twenty-one cases (95.45%) of the combined flaps survived completely. One case had partial necrosis of the distal part of the flap, which was healed by second-stage skin grafting. The donor sites of the flaps were closed directly and achieved primary healing without complications. The follow-up period ranged from 3 to 38 months with an average of 20 months. All the cases had good wound healing and limb functional recovery. Conclusion The combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery is an effective method for repairing large skin and soft tissue defects of upper extremities. The operation is simple, the perforator vessel is reliable and the flaps can be cut in large area with less damage to donor site. Key words: Upper extremity; Surgical flaps; Descending branch of lateral circumflex femoral artery; Upper extremity reconstruction