Sequential chimeric free deep circumflex iliac artery bone flap and superficial circumflex iliac artery perforator flap from the same site for one-stage reconstructions of severe hand injury: A report of two cases

Abstract

Summary Two flaps, namely the free vascularized iliac bone graft supplied by the deep circumflex iliac artery (DCIA) and the superficial circumflex iliac artery perforator flap supplied by the superficial circumflex iliac artery (SCIA), can be individually harvested from a single surgical field. We report two cases treated by these free flaps for severe hand injury with large skin defect and osteomyelitis. Sequential chimeric flaps were anastomosed between the ascending branch of the DCIA and the SCIA. The advantage of this method is more freedom in the flap insetting for complex tissue defects. For this reason, this method is also excellent for cosmetic appearance. Furthermore, donor site morbidity can be minimized because the flaps are harvested from the same site.

“Free chimeric SCIAP flap in reconstructing the distal complex extensor tendon injury.”

“…Plastic and Reconstructive Surgery • February 2024 workhorse for small or medium limb defects. [7][8][9][10] The SCIAP flap has been especially indicated for acral resurfacing (ie, thumb or hallux) because of its thinnest superficial skin fascia (an average of 5 mm). 23 If needed, the SCIAP flap can be tailored as a pure skin flap, aided by the microdissection or worm-eating technique.…”

“…The chimeric superficial circumflex iliac artery perforator (SCIAP) flap has been favored as an osteocutaneous or fasciocutaneous flap. [7][8][9] The possibility of free osteofasciocutaneous SCIAP flap theoretically exists because of its versatile perfusion from the same source artery [the superficial circumflex iliac artery (SCIA)]; however, practical application is lacking. [10][11][12][13] In our practice, we adopted the tripartite SCIAP flap to tackle the distal complex extensor tendon injury.…”

The honourable Professor Isao Koshima: historical contribution from microsurgery to Nanomicrosurgery

“…All of these achievements were accompanied by active teaching by Professor Koshima, who continues to participate in numerous live surgery demonstrations in over 20 countries since 1997 [5][6][7][8][9][10] Professor Isao Koshima was the first to describe the versatile application of ALT flaps in head and neck area. Since 2002, the use of this flap has become the method of choice for the reconstruction of head and neck defects in Taiwan and USA, thanks to his description of the anatomical characteristics of perforating vessels, such as intramuscular and intermuscular septum perforating vessels [11,12,[22][23][24] 2006 Penile and urethral reconstruction Isao Koshima performs free radial forearm osteocutaneous flap with vascular pedicle transfer and chimeric SCIP flap for urethropenile reconstruction [4] As can be seen, Professor Isao Koshima made several revolutionary achievements in the field of plastic and reconstructive surgery. In 1983 he proposed the concept of a nerve graft, in 1989 he introduced the first perforator flap by inventing the DIEP flap, in 1990 he introduced the lymphove nous anastomosis and coined the term "supermicrosurgery".…”

Sequenzieller chimärer Beckenkamm-SIEA-Lappen zur Rekonstruktion eines osteokutanen Defektes des Unterschenkels und die Wichtigkeit zur Schonung des Ramus Ascendens – ein Fallbericht

“…Erstens ergebe sich durch die getrennte Deckung des ossären und kutanen Defektanteils ein größerer Umfang an Freiheitsgraden und daraus folgend eine bessere Anpassung der Transplantate an komplexe Defekte [10]. So berichten Matsumoto und Kollegen in Fällen von schwerwiegender Handverletzung eine gute Defektdeckung mittles freien Knochentransplantat gehoben an der DCIA und einem sequenziell daran angeschlossenen kutanem A. circumflexa ilium superficialis Perforator (SCIP) -Lappen erzielt zu haben [10].…”