The Effectiveness of Pedicled Groin Flaps in the Treatment of Hand Defects: Results of 49 Patients

被引:31
作者
Goertz, Ole [1 ]
Kapalschinski, Nicolai [1 ]
Daigeler, Adrien [1 ]
Hirsch, Tobias [1 ]
Homann, Heinz H. [1 ]
Steinstraesser, Lars [1 ]
Lehnhardt, Marcus [1 ]
Steinau, Hans U. [1 ]
机构
[1] Ruhr Univ Bochum, Dept Plast Surg, Sarcoma Reference Ctr, BG Univ Hosp Bergmannsheil,Burn Ctr, D-44789 Bochum, Germany
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 2012年 / 37A卷 / 10期
关键词
Hand injury; hand trauma; pedicled groin flap; ISCHEMIA; SURGERY;
D O I
10.1016/j.jhsa.2012.07.014
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose Despite the growing number of free and local flaps used for repairing defects of the hand, groin flaps are also still widely used. The aims of this study were to evaluate the outcome of a large series of patients whose defects were covered by pedicled groin flaps, and to find out whether it is still indicated in replacing damaged soft tissue of the hand in the era of microsurgery. Methods From 1982 to 2009, we treated 85 patients with soft tissue defects on the hand and distal forearm with pedicled groin flaps in our department and recorded them in a prospective database. We interviewed and examined 49 patients in this cohort. Results The mean age of the 85 patients was 33 years, the male/female ratio was 4:1, the mean hospital stay was 29 13 days, and the mean follow-up was 9 years. The duration to flap division was 24 +/- 5 days. Altogether, we performed a mean of 4.6 operations per patient, including thinning of the flap, deepening of the interdigital fold, and stump and flap revisions. One flap loss occurred. Of the 49 patients, results were mostly classified as good, and 82% of patients would undergo the procedure again. The mean Disabilities of the Arm, Shoulder, and Hand score value was 23 +/- 17. The Vancouver Scar Scale showed nearly normal height and vascularity of the groin flap (0.2 +/- 0.4 and 0.3 +/- 0.6, respectively), pigmentation was slightly abnormal (0.8 +/- 0.6), and pliability was evaluated between "supple" and "yielding" (1.5 +/- 1.2). Conclusions Results achieved with the groin flaps were positive. Most patients were satisfied with the results, and the operation was easily performed when McGregor's recommendations were followed. Nevertheless, considering the high number of secondary operations, the long hospital stay, and immobilization of the arm, groin flaps should be used only when free flaps or regional pedicle flaps are either not feasible or not indicated. (J Hand Surg 2012;37A:2088-2094. Copyright (C) 2012 by the American Society for Surgery of the Hand. All rights reserved) Type of study/level of evidence Therapeutic III.
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收藏
页码:2088 / 2094
页数:7
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