TREATMENT OF SOFT TISSUE DEFECTS ON WRISTS, PALMS AND FINGERS USING PEDICLE GROIN SKIN FLAP - CASES REPORT

Tan Phat Nguyen1,, Thanh Tan Nguyen1, Duc Hiep Ngo 1, Thanh Tan Mai 1, Tu Thai Bao Nguyen1, Huu Dat Nguyen1, Trung Nhan Nguyen1, Tuan Kiet Tran 1, Ngoc Thien Ho 1, Thanh Hai Nguyen1
1 Can Tho University of Medicine and Pharmacy

Main Article Content

Abstract

Background: Hands play an important role in making social interactions, working, and interacting with the surroundings. Hand injuries are very varied and common in our daily lives. Skin grafting cannot close large open wounds exposing tendons, bones, blood vessels, or nerves. In this case, it needs to be treated with a skin flap. The pedicled groin skin flap is safe to treat wrists, hands, and fingers soft tissue defects. Objective: To survey and evaluate of results of treatment of soft tissue defects in the wrist and finger area using seamless pedicle inguinal flap. Materials and Methods: Case series report patients with soft tissue defects of the wrist, hands, and finger were treated with pedicle groin flaps in Can Tho Central General Hospital from 2022 to 2023. Results: Research on 4 male patients with an average age from 23-37 years old) with software defects of wrists, hands, and fingers due to electric burns and traffic accidents who were treated with a seamless inguinal flap with an average flap size from 12 - 96 cm2. All of the surgeries were successful. Then, we evaluated the result by recording the viability of the flaps and patients’ satisfaction. Conclusion: A pedicle groin flap is a safe and effective way to treat wrists, hands, and finger soft tissue defects. This method can be used in many places with only basic techniques and without the aid of high-tech equipment but can still yield good and consistent results.

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References

1. Trần Văn Dương, Nghiên cứu giải phẫu và ứng dụng vạt bẹn dạng tự do trong điều trị khuyết hổng mô mềm ở chi thể, Luận án Tiến sĩ Y học, Viện nghiên cứu khoa học y dược lâm sàng 108. 2016.
2. Nguyễn Đức Thành, Nghiên cứu giải phẫu mạch máu vạt bẹn và đối chiếu với ứng dụng trong phẫu thuật tạo hình, Luận án Tiến sĩ Y học, Trường đại học Y dược Hà Nội. 2018.
3. Almeshal, O., Aldekhayel, S., & Alshomer, F. (Eds.). Soft Tissue Reconstruction of the Hand: Loco-regional and Distant Flaps Selection and Approach. Springer. Chaper Groin Flap:207–211. 2022.
4. Jackson DM. [The diagnosis of the depth of burning]. Br J Surg. 1953 May;40(164):588-96. Undetermined Language. doi: 10.1002/bjs.18004016413. PMID: 13059343.
5. McGregor IA, Jackson IT. The groin flap. Br J Plast Surg. 1972 Jan;25(1):3-16. doi: 10.1016/s0007-1226(72)80003-1. PMID: 4550433.
6. Hong, J. P. The Superficial Circumflex Iliac Artery Perforator Flap in Lower Extremity Reconstruction. Clinics in Plastic Surgery, 2021, 48(2), 225–233. doi:10.1016/j.cps.2020.12.005.
7. Gandolfi, S., et al. Vascularization of the superficial circumflex iliac perforator flap (SCIP flap): an anatomical study. Surgical and Radiologic Anatomy, 2020. 42 (2020): 473-481.
8. Zubler C, Haberthür D, Hlushchuk R, Djonov V, Constantinescu MA, Olariu R. The anatomical reliability of the superficial circumflex iliac artery perforator (SCIP) flap. Ann Anat. 2021 Mar;234:151624. doi: 10.1016/j.aanat.2020.151624. Epub 2020 Oct 28. PMID: 33129977.
9. Fukaya E, Kuwatsuru R, Iimura H, Ihara K, Sakurai H. Imaging of the superficial inferior epigastric vascular anatomy and preoperative planning for the SIEA flap using MDCTA. J Plast Reconstr Aesthet Surg. 2011 Jan;64(1):63-8. doi: 10.1016/j.bjps.2010.03.012. Epub 2010 Apr 14. PMID: 20392682.
10. Tashiro K, Harima M, Kato M, Yamamoto T, Yamashita S, Narushima M, Iida T, Koshima I. Preoperative color Doppler ultrasound assessment in planning of SCIP flaps. J Plast Reconstr Aesthet Surg. 2015 Jul;68(7):979-83. doi: 10.1016/j.bjps.2015.03.004. Epub 2015 Mar 19. PMID: 25824198.
11. Schiltz D, Lenhard J, Klein S, Anker A, Lonic D, Heidekrueger PI, Prantl L, Jung EM, Platz Batista Da Silva N, Kehrer A. Do-It-Yourself Preoperative High-Resolution Ultrasound-Guided
Flap Design of the Superficial Circumflex Iliac Artery Perforator Flap (SCIP). J Clin Med. 2021 May 30;10(11):2427. doi: 10.3390/jcm10112427. PMID: 34070779; PMCID: PMC8198546.
12. Amouzou, Komla Sena, et al. The pedicled groin flap in resurfacing hand burn scar release and other injuries: a five-case series report and review of the literature. Annals of burns and fire disasters 30.1 (2017): 57.
13. Goertz, Ole, et al. The effectiveness of pedicled groin flaps in the treatment of hand defects:
results of 49 patients. The Journal of hand surgery 37.10 (2012): 2088-2094.