Application Of Double Pedicled Flap In The Repair Of Wounds After Resection Of Skin Tumor:A Report Of 20 Cases

Objective: To explore the application and significance of double pedicle flap in repairing various skin defects in our department.Method: From 2010 to 2019,20 patients with skin tumors and skin defects were collected in the dermatology department of the second hospital of Jilin University.After the removal of the tumor,the patients with skin defects were repaired with double pedicle flaps.The results were evaluated and the advantages and disadvantages of the repair were obtained.Result: The survival rate of flap was 85%,3 cases had necrosis below 20%.75% of the patients were similar,25% of them were soft,20% of them were bloated,1 patient had slight pain,4 patients showed slight itching.In addition,45% of the patients had partial epidermal necrosis in the valve area.According to the subjective evaluation of the patients,the aesthetic satisfaction rate was 70%,the rate of no conscious symptom was 75%,and the rate of no influence on activity was 90%.Among them,1 case of lower extremity and 1 case of shoulder had mild limitation of conscious activity.Conclusion: 1.The operation of double pedicled flap is simple,with less additional incision.It is more beautiful than skin grafting and other arbitrary flaps.It can reduce the length of hospitalization and improve the compliance of patients.2.The double pedicle flap has abundant blood supply,high flap survival rate and few postoperative complications.3.It is safe to use any pedicled skin flap within 1.5:1,and it is suitable to use it in the face and the relaxed part up to 2:1,and the distal part of the leg up to 1:1.Because of the double blood supply and the integrity of the tissue between the flaps,the ratio of length to width of the distal part of the leg can reach 2:1.If the long axis of the flap is consistent with the direction of the blood vessels on the body surface,it can be extended to 4:1.4.Disadvantages of double pedicled flap: it should be used cautiously in the tumor with high malignancy;the displacement distance is limited,and the scar is easy to form near the joint or in the part with high activity,and two parallel scars are formed after operation.When the pressure is insufficient,dead cavity and subcutaneous congestion may occur.5.The double pedicle flap can be used in many extension applications.According to the location and defect shape,it can be designed as V-shaped,irregular shape and so on.Among them,its design line is parallel to the skin tension line,or it is suitable to hide in the wrinkle line and the concealed part of the body.