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Reconstruction of Moderate-Sized Hand Defects Using a Superficial Lateral Sural Artery Perforator Flap

He, Xiao-qing MD; Zhu, Yue-liang MD; Duan, Jia-zhang MD; Yang, Xi MM; Feng, Fanzhe MM; Xu, Yong-Qing MD, PhD

doi: 10.1097/SAP.0000000000000898
Hand Surgery

Background The skin on the lower leg has abundant perforators and, thus, is an excellent donor site for transplant tissue flaps. However, due to vascular variations and body positions, tissue flaps at the posterolateral proximal portion of the lower leg are rarely used for transplantation. This study reports our experience with the use of superficial lateral sural artery perforator (SLSAP) flaps in the repair of moderate-sized hand wounds.

Methods From March 2012 to April 2015, the hand wounds of 15 patients were planned for repair using a superficial sural artery perforator flap. In total, 6 patients had a defect in the palm of the hand, 5 in the dorsum of the hand, and 3 in the finger; 1 patient sustained a contracture of the first web space.

Results In 12 of the 15 cases, an SLSAP flap was successfully harvested. In the remaining 3 cases, the planned harvest of an SLSAP flap was converted to the harvest of a superficial medial sural artery perforator flap during the operation. The flaps ranged in area from 1.8 × 3.8 cm to 5.5 × 6.5 cm. Primary suture of the donor site was performed in all cases. Dissection of the muscular tissue was avoided. After the operation, venous crisis occurred in 1 case, and a partial area of necrosis developed at the distal end in 1 case. The flap survived in all other cases.

Conclusions Our experience showed that the SLSAP flap is suitable for reconstruction of moderate-sized hand defects.

From the *Department of Orthopaedic Surgery, Kunming General Hospital of Chengdu Military Command, Kunming; and †Graduate School, The Third Military Medical University, Chongqing, China.

Received June 6, 2016, and accepted for publication, after revision, August 2, 2016.

Conflicts of interest and sources of funding: none declared.

Reprints: Yong-Qing Xu, MD, PhD, Department of Orthopaedic Surgery, Kunming General Hospital of Chengdu Military Region, 212, Daguan Road, Kunming, Yunnan Province, China. E-mail: hxq00@foxmail.com.

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