Clinical Analysis Of Three Kinds Of Flaps Repairing Small Area Soft Tissue Defect Of Fingers

Objective: To compare the clinical efficacy of repairing the soft tissue defect of fingers using pedicled abdominal flap,cross-finger flap and the cutaneous branches-chain flap of hand.To provide reference for the best surgical repair of finger soft tissue defect.Methods: This study collected a total of 69 cases with 71 fingers of fingers soft tissue defects of hand surgery in The Fifth Affiliated Hospital of Zunyi Medical University from March 2012 to March 2017.Patients consisted of 51 males and 18 females,and aged 18 ~53 years old,with average 30.3 years old.They were divided into three groups by operation methods,including pedicled abdominal flap /(group I),cross-finger flap /(group II),and cutaneous branches-chain flap of hand /(group III).Group I: 25 cases with 27 fingers.Group II: 24 cases with 24 fingers.Group III: 20 cases with 20 fingers.The preoperative preparation and postoperative routine treatment of the three groups were same.Patients were regular followed up for 3 months,6 months and 12 months postoperatively,and the results of 12 months follow-up were selected.According to the evaluation standard of hand function and the advanced evaluation of flap,the study subjects were evaluated comprehensively.Statistical methods were employed to compare the results of hospitalization,hand function and the advanced evaluation of flap,and the differences between the groups were analyzed.Results: In this study,all 69 cases with 71 fingers of flaps were survived,and the results of 12 months follow-up were selected.Group I: The appearance of the flap is more bloated,and it need to pedicle division at the second time.Some of them need to be reshaped,which is soft and brittle.The excellent rate of hand function was 56.0%,and the excellent rate of the flap was 51.9%.Group II: The flap is not bloated,the skin texture and elasticity are good,and the skin is resistant to friction,but the donor site need making skin grafts and it also need to pedicle division at the second time.The excellent rate of hand function was87.5%,and the excellent rate of the flap was 87.5%.Group III: The appearance of the flap is beautiful,not bloated,the area skin color,texture and the surrounding skin are close,resistance to friction,the donor site can be directly sutured.The excellent rate of hand function was 90.0%,and the excellent rate of the flap was 95.0%.General data(including gender,age)of the three groups were not statistically significant(P>0.05).Total hospitalization days and total hospitalization expenses were statistically significant(P<0.05).Group III had the lowest total hospitalization time,and its total hospitalization costs are lower than group I and group II.After 12 months of follow-up,the difference in hand function between the three groups was statistically significant(P<0.05),group II and III were better than group I.There were statistically significant differences in the evaluation of flap in the three groups(P<0.05),group II and III were better than group I.Conclusion:(1)The cutaneous branches-chain flaps of the hand reparing the small area soft tissue defect of fingers had the lowest total hospitalization time,and its total hospitalization costs was lower than pedicled abdominal flaps and cross-finger flaps.(2)Both cutaneous branches-chain flaps of hand and cross-finger flaps reparing the small area soft tissue defect of fingers postoperative hand function recovery and the advanced evaluation of flaps were superior to pedicled abdominal flaps.