Repairing Soft Tissue Defects By Using Intercostal Artery Perforator Flaps

Objective:To investigate the feasibility and advantages of repairing soft tissue defects of the multiple areas in hand,foot and face by using the intercostal artery perforator free flaps,and of repairing soft tissue defects in the trunk by using the intercostal artery perforator propeller flaps.To provide reliable theoretical basis for the clinical application of the ICAP flaps.Methods:We retrospective analyzed 24 cases by using 29 intercostal artery perforator flaps for repairing soft tissue defects,including posterior inter-costal artery perforator propeller flaps to repair the dorsal and lateral tho-racic trunk in 5 cases,free dorsal intercostal artery perforator flap was used to repair hand and foot in 8 cases,anterior intercostal artery perfora-tor propeller flap repaired anterior sternum in 7 cases,and free anterior intercostal artery perforator flap in 3 cases in our center from June 2011to June 2019.Results:A total of 29 intercostal artery perforator flaps were successfully im-plemented,including 6 dorsal intercostal artery perforator propeller flaps on the upper back and 8 anterior intercostal artery perforator propeller flaps in lower sternum,all of which were covered the soft tissue defects after resection of keloids;1 dorsolateral intercostal artery perforator pro-peller flap to repair the left thoracic flap;10 dorsal intercostal artery per-forator flaps to repair hand and foot soft tissue defects;4 anterior inter-costal artery perforator free flaps to repair facial soft tissue defects.The soft tissue defect area ranged from 9×5cm~2 to 22×15cm~2,and the mean follow-up time was 17.7(6-42 months)months.One case had marginal necrosis.There was no flap necrosis.Local flap was covered in the donor site in one case,and the rest were all directly closed,one donor rupture,2patients had local hematoma.There was no keloid recurrence.The aver-age age of the patients was 36.9 years(9-68 years),10 men and 14 women.Conclusions:1.Repairing large areas of soft tissue defects on the back of the trunk,lateral chest wall,lower sternum,hands,feet and faces by using ICAP including DICAP,DLICAP and AICAP is stable and effective sur-gical method.2.According to the results of long-term follow-up,the propeller flaps based on the 6th AICAP and DICAP combined with early postoperative radiotherapy provides an effective and feasible method for the surgical treatment of keloids on the upper back and lower sternum.