Application Of Free Bilobate Flap Of Hypogastrium In Reconstruction Of Hand And Foot Defects

Objective The study was conducted to determine the surgical approaches and evaluate the clinical efficacy of application of free bilobate flap of hypogastrium in reconstruction of hand and foot wounds at one time.Methods nine cases of multiple parts of the hand and foot skin and soft tissue wounds were treated with the bilobate flap of the the iliac artery and superficial epigastric artery reconstruction, in which two cases were foot wounds(degloving wond of anterior foot in one case and two wonds in another case), and seven cases were hand wounds(three wonds at most,two wonds at least). The skin and soft tissue wounds area was 3.0cm x2.0cm ~ 15.0cm x 5.0cm,18 flaps in total.The flap area was 6.0cm x 3.0cm ~ 19.0cm x7.0cm. Results Eight of the nine cases in this group were survival, one case was distal partial necrosis and the scar was healed after one month by changing medical prescription.The patient were followed-up for 5 to 21 months, with an average of 10 months, the skin flap was fine quality, and four cases were slightly bloated in appearance, the flap restored protective sensation, the two cases to reconstruct the foot wounds have no effect on walking after restriction. Seven cases to reconstruct the hand wounds, five cases of which finger flexion and extension were good, flap edge of two cases appeared the scar contracture and impacted the finger dorsiflexion, and finger function were improved after stage two scars reconstruction. There was only a linear scar in the donor site of abdomen and was not discomfortable.Conclusion Application of free bilobate flap of hypogastrium in reconstruction of hand and foot wounds can reconstruct multiple skin wounds, the donor site is covert and can be direct sutured, it is a ideal method of reconstruction of hand and foot defects.