The Clinical Study Of Multiple Free Micro Perforator Flaps Based On The Posterior Interosseous Artery For Simultaneous Repairing Multiple Soft Tissue Defects Of Hand

Objective: To explore the methods and effect of using multiple free micro perforator flaps based on the posterior interosseous artery for simultaneous repairing multiple soft tissue defects of the hand.Methods: From July 2007 to October 2010,7 patients of soft tissue defects of the hand were treated with 14 multiple free micro perforator flaps based on the posterior interosseous dorsal arteries.This group of 14 fingers in 7 cases,8 fingers of male in 4 cases and 6 fingers of female in 6 fingers.The patients′age ranged from 16 to 45 years,with an average of 26 years.Wound area:the volar defects in 3 fingers,the dorsal defects in 6 fingers and the lateral defects in 5 fingers.The sizes of the defects were from 1.30 ㎝×1.05 ㎝ to 5.50 ㎝×2.45 ㎝ and the sizes of the flaps were from 1.60 ㎝×1.35 ㎝ to 6.00 ㎝×3.00 ㎝.Results: The 14 flaps in 7 cases all survived.One flap occured higher tension and blisters in the distal area 1 day after surgery,it was improved 3 days later with protected cover with gauze,incision bleeding and wet compress with heparin cotton.These cases were follow-up for 6 to 18 months,average 12 months.The color and appearance of the flap was satisfactory.Oneskin flap was somewhat swelling and a decorating operation was performed,linear scars in the donor sites.The 2-PD of the flaps in 7 fingers restored to 6-10 mm,with an average of 8mm.No cases of hyperalgesia,no cases result in disuse because of the tenderness.According to the upper extremity functional evaluation standard set up by hand surgery branch of Chinese Medical Association,the results were excellence in 6 patients,good in 1 patient,94.6% of fineness was reached.Conclusions: It is an ideal surgery method to choose multiple free micro perforator flaps based on the posterior interosseous artery for repairing multiple soft tissue defects of the hand.