Free Vascularized Anterolateral Thigh Fascia Lata Flap for Reconstruction in Electrical Burns of the Severely Damaged Finger

Reconstruction of Finger Soft Tissue Defects With a Thinned Free Anterolateral Thigh Flap

BACKGROUND

Reconstructing complex soft tissue defects of the finger requires both functional and aesthetic aspects. There are many free tissue transfers as suitable options for digital resurfacing. The anterolateral thigh (ALT) flap is not the first choice for reconstruction of this area because it has the disadvantage that the subcutaneous tissue is too thick; however, its use as a thinned form has yet to be described much. This study presents the flap thinning technique in the small-sized ALT flap for the finger soft tissue defect.

METHOD

From May 2009 to March 2018, 10 patients with complete circumferential or semicircumcision defects in the fingers underwent reconstructive procedures that included thinned ALT flap transfer. Finger soft tissue damage due to contusion trauma includes loss of skin and exposure of the bone and tendon. The flap is thinned in 2 different ways: peripheral thinning and total microsurgical thinning, which is selected based on the perforator vessel structure of the flap.

RESULT

The ALT flap sizes, averaging 4-9 cm wide and 6-12 cm long, were thinned to 4-7 mm. One perforator was included in the flaps with a pedicle length average of 6.1 cm. The flaps survived entirely in all patients except one with a 30% area in the distal part of the thinned ALT flap that became necrotic because of venous occlusion. Donor sites were closed primarily for all patients. No patients required secondary flap defatting.

CONCLUSIONS

The small thinned ALT perforator flap can be an excellent option for full circumferential or semicircumferential soft tissue defects of the finger. Follow-up showed this as an excellent alternative for finger reconstruction in terms of aesthetic appearance and functional outcome.

Lateral Circumflex Femoral Vascular Chimeric Fascia Flap Reduces Pain and Promotes Wound Healing in Repairing Skin and Tendon Defects of Hand, Foot, and Ankle

The purpose of this study was to investigate the clinical efficacy of lateral circumflex femoral artery embedded with fascia lata flap in the repair of skin and tendon defects in hand, foot, and ankle. From January 2020 to June 2021, 32 patients with skin and tendon defects of the hand, foot, and ankle admitted to our hospital were selected as the study subjects. According to the random number table method, they were divided into the observation group (16 cases, treated with rotational lateral femoral vascular inlay broad fascial flap repair) and the control group (16 cases, treated with conventional skin flap repair) and followed up for 6 months. The postoperative tendon midactivity measurement scale (TAM), ankle-hindfoot scoring system (AOFAS), and lower limb functional evaluation scale (LEFS) scores were all higher in the observer group than in the control group The number of people with infection, implant necrosis, and subcutaneous hematoma in the observation group (total incidence 6.25%) was less (lower) than that in the control group (50.00%), and the total number of people with significant and fair clinical efficacy in the observation group (total effective rate 100.00%) was more (higher) than that in the control group (68.75%). The application of early plastic surgery to the clinical treatment of patients with deep burns on the hand can reduce the patient's pain and promote the healing of the wound. It is of great significance to reduce the risk of complications such as necrosis of the skin graft and improve the efficacy of the surgery.