Reconstruction of Soft Tissue Defects in the Hand with a Free Anterolateral Thigh Deep Fascia Flap

Abstract

Objective To report our experience in the reconstruction of soft tissue defects in the hand with a free anterolateral thigh deep fascia flap and describe the clinical outcomes. Methods This study was a retrospective trial. From November 2016 to January 2020, six patients (four men and two women) with soft tissue defects in the hand were included in this study. The average age of the patients was 33.7 ± 12.7 years (range, 20 to 50 years). All patients underwent reconstructions with free anterolateral thigh deep fascia flaps. Relevant clinical characteristics were recorded prior to surgery. The size and thickness of the deep fascia flap and the thickness of the skin were measured intraoperatively. The survival of the flaps and skin grafts and the occurrence of infection were recorded after the operation. At follow‐up, donor site complications and postoperative effects were evaluated according to the outcome satisfaction scale. The pain in the injured hand was assessed using the visual analog scale. Results The average body mass index (BMI) was 26.6 ± 1.7 kg/m2 (range, 23.9 to 28.7 kg/m2). The defect sizes ranged from 5 cm × 5 cm to 13 cm × 8 cm (average, 53.1 ± 27.9 cm2). The six anterolateral thigh deep fascia flaps ranged from 7 cm × 6 cm to 14 cm × 9 cm in size (average, 71.8 ± 29.1 cm2). The thicknesses of skin ranged from 25 mm to 40 mm (average, 32.5 ± 4.8 mm), and the thicknesses of the deep fascia flaps ranged from 2 mm to 3 mm (average, 2.5 ± 0.5 mm). After the operation, the blood supply of the deep fascia flap was normal in all cases. The second‐stage skin grafts of most patients survived completely. The skin graft in one case was partially necrotic and healed after a dressing change. No infection occurred. At follow‐up (average, 16.3 ± 6.9 months), there was only a linear scar and no loss of sensation at the donor site of each patient. According to the outcome satisfaction scale, the outcome satisfaction score ranged from 6 to 8 (average, 7.2 ± 0.9), all of which were satisfactory. Apart from one patient who reported mild pain, all the other patients reported no pain. Three typical cases are presented in this article. Conclusions The free anterolateral thigh deep fascia flap, which is suitable for reconstruction of soft tissue defects in the hand, can provide very good outcomes both functionally and aesthetically.

Inflammation Self‐Limiting Electrospun Fibrous Tape via Regional Immunity for Deep Soft Tissue Repair

“…Considering some critical settings, such as first aid in a car accident or severe trauma, wound treatment on the battlefield or defect filling after tumor resection, this cytokine scavenging tape is of particular value to rescue a limb, an organ or even a life. [ 35 ] The reported design includes no drug or bioactive ingredients that the efficiency should be considered when applied to actual wound circumstances. Despite the safe components, convenience and potential clinical value, the tape's inflammation self‐limiting and tissue repair efficiency need to be evaluated in bigger animals that simulate human body physiology with more specific injury models.…”

Superficial Circumflex Iliac Artery Perforator Flap with Bilobed Design for the Donor Defect after Wrap‐Around Flap Transfer Reconstruction

“…Thumb injuries leading to amputation are more common in daily life 20 . In 1980, Morrison et al first used a wraparound neurovascular free flap from the great toe successfully to reconstruct an amputated thumb 3 .…”

“…Thumb injuries leading to amputation are more common in daily life. 20 In 1980, Morrison et al first used a wraparound neurovascular free flap from the great toe successfully to reconstruct an amputated thumb. 3 This procedure has been widely used because it is excellent for reconstructing thumbs both aesthetically and functionally.…”

Various soft tissue defect reconstructions using anterolateral thigh and vascularized fascia lata composite free flap

“…Multilobed deep fascia flaps can also be harvested according to needs for defect. [ 31 ] The fascia can be used for a variety of reconstruction purposes by collecting thick and strong FL during flap harvest. It can be versatile reconstruction option for various situations.…”