Biomedical Research

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Skin defect of forearm repaired by anterolateral thigh flap combined with external fixation

Objective: To explore clinical efficacy of forearm skin defect repaired by anterolateral thigh flap combined with external fixation.

Methods: Twelve patients hospitalized in Jinshan hospital with forearm skin defect from October 2008 to June 2013 were retrospectively analysed. Area of forearm skin defect ranged from 9.5 cm × 4.5 cm to 20.5 cm × 12.0 cm. Ten patients were operated with emergent debridement, repairing blood vessels, nerves, muscles and fixing bone fracture within 8 h after broken called as the first phase. Twelve patients were repaired forearm skin defect used anterolateral thigh flap within 10 days called as the second phase.

Results: Average follow-ups time was 15 months. Cut scope of flap ranged from 11.5 cm × 5.5 cm to 25.5 cm × 14.5 cm. Wound of 10 patients were healed in first phase and healing time were 14-18 days. Free flap and skin-grafting were survived perfectly, and the active activity of f wrist was normal. Although 1 patient was with part of flap necrosis, wound was healed through changing drug in the second phase. In addition, 1 patient had flap necrosis at the 3rd day after the surgery and recovered after surgery of ipsilateral pedicled groin flap. The fineness rate was 92.7% (11/12).

Conclusions: External fixation can effectively fix open fractures of forearm injuries and provide more time to flap surgery. Anterolateral thigh flap is the ideal flap to repair forearm skin defect combined with muscles and bone exposure, which characteristics were anatomical fixing position, high survival rate and good recovery of forearm function and appearance.

Author(s): Rongbo Wu, Zhenchao Gao, Fangyi Chen, Mingxin Wang, Zhiyong Liu, Xinchao Zhang