Wu Lehao,Tong Dedi,Zhu Shan,Zang Mengqing,Tian Guanglei,Chen Shanlin.[J].Chin J Traumatol,2014,17(5):256-260. [doi]
Consecutive flap transfer for repairing massive soft tissue defects in the opisthenar with improved donor site closure
  
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KeyWord: Soft tissue defect  Free scapular flap  Perforator flap
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Author NameAffiliation
Wu Lehao Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China
Department of Hand Surgery, Jishuitan Hospital, Peking University, Beijing 100035, China
Division of Plastic and Reconstructive Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030, China 
Tong Dedi Department of Hand Surgery, Jishuitan Hospital, Peking University, Beijing 100035, China 
Zhu Shan Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China 
Zang Mengqing Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China 
Tian Guanglei Department of Hand Surgery, Jishuitan Hospital, Peking University, Beijing 100035, China 
Chen Shanlin Department of Hand Surgery, Jishuitan Hospital, Peking University, Beijing 100035, China 
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Abstract:
      Objective: To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site morbidity. Methods: Six patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular flaps. Afterwards, a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct closure. Results: All six free scapular flaps survived without signs of infection. Three adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex, which resolved after six weeks with only conservative therapy. All the incisions healed without other complications. At six-month follow-up, the patients regained full shoulder function. Conclusion: With the assistance of an adjacent pedicled flap, the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the opisthenar. It can achieve positive outcomes in both reconstructive and aesthetic aspects.
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