|
Back to 2017 Scientific Program ePosters
The Chimeric Superficial Circumflex Iliac Artery Perforator Flap is an Effective Option for Reconstruction of Osteocutaneous Defects of the Hand
Jia Dong Pan, MD, MA1; Xin Wang, MD1; Jacques Henri Hacquebord, MD2; Yaopeng Huang, MD1; Hong Chen, MD1; Weiwen Zhang, MD1
1Ningbo 6th Hospital, Ningbo, China, 2NYU Hospital for Joint Diseases, New York, NY
Introduction: Osteocutaneous defects of the hand often necessitate multiple donor sites to address soft tissue and bony defects. We believe that a single chimeric perforator flap based on the superficial circumflex iliac artery (SCIA) is a reliable option for effective reconstruction of osteocutaneous defects of the hand.
Methods: A retrospective review of all patients with osteocutaneous defects of the hand reconstructed with a chimeric SCIA perforator (cSCIP) flap were included in this study. The SCIA is the common pedicle in the cSCIP flap which contains a perforator to skin and another vascular branch to the iliac crest. Demographic information, injury mechanism, soft tissue defect size and location, bony defect size, chimeric flap size, and post-operative complications were collected. Success of soft tissue coverage and bony union were the primary outcome measures.
Results: A total of 7 patients were reviewed with a mean follow of 14 months (8-21 months). 6 patients had bony defects of a single metacarpal and one patient had a defect of the thumb proximal phalanx. Machine injury was the mechanism for all patients. Average skin defect size was 27.8cm2 (4.8-91.0 cm2) and average bony defect length was 2.51cm (1.5-3.0cm). In the cSCIP flap, average bone length was 2.93cm (2.0-3.5cm) and average skin area was 34.7cm2 (6.4-105.0 cm2). Bony union was successful in 5/7 of the cases at an average of 11.5 weeks (8-16 weeks) with the remaining two patients requiring second stage non-vascularized ICBG. 6/7 patients had complete flap survival. The remaining patient required a secondary skin graft for partial superficial necrosis. At final follow up, average ROM of the affected metacarpophalangeal joints was 52.5 degrees (30-75 degrees). The patient with a thumb proximal phalanx defect was successfully treated with fusion of the affected joints.
Conclusion: Donor site morbidity for the cSCIP flap is minimal and-similar to that of non-vascularized ICBG harvest and pedicled groin flap. With a single stage procedure, the cSCIP flap provided successful soft tissue coverage and bony union in 85% and 70% of cases, respectively. The cSCIP flap is an excellent option for reconstruction of complex defects of the hand. | a) |  | a) |  |
Back to 2017 Scientific Program ePosters
|
