The application of thin flap repairing method after reascularization in femoral anterolateral free flap

Abstract

Objective: To summarize the application and effect of thin flap repairing method after reascularization in femoral anterolateral free flap.

Methods: From May 2013 to October 2015, 20 cases of patients received femoral anterolateral free flap transplantation, with the flap transported to the recipient site. After reascularization, the phase I of thin flap repairing was performed in each “vein type” area. Among those, there existed 8 cases of direct suture in the donor site, and 12 cases of skin transplantation by intermediate split thickness skin graft.

Results: All the postoperative flaps survived, with 2 cases of vascular crisis and 2 cases of poor venous return at the edge of flap. No complications such as flap infection and necrosis occurred. Wounds and incisions in donor and recipient sites were healed in phase I. 20 cases of patients had been followed up for 5-24 months, and the average follow-up time was 15 months. The skin texture of flap was similar to the surrounding skin, with good abrasion resistance, no ulceration and no phase II flap repairing; the sensation of flap recovered to S3-S4 level; the two-point discrimination was 3.5-6.0 mm, with the average value of 5.0 mm. The function of patients’ fingers recovered well without any complications such as contracture and deformity etc. In the last follow-up, Testative Evaluation Standard of Upper Limb Function, which was established by Chinese Medical Society for Surgery of Hand, was used to assess efficacy, and the evaluation results were as follows: excellent in 9 cases, good in 5 cases, fair in 6 cases; in accordance with the evaluation criteria listed in Michigan Hand Outcome Questionnaire (used to assess patients’ satisfaction with the appearance of flaps after operation, and the results were as follows: very satisfactory in 9 cases, satisfactory in 9 cases, and moderate in 2 cases.

Conclusions: After reascularization in femoral anterolateral free flap grafting, phase I of thin repairing has small effects on flap vascularization, with a satisfactory appearance of the flap.