[Clinical experience of flap appliance in soft tissue defects of upper extremity]

To discuss the advantages and disadvantages of flaps in the repair of soft tissue defects in upper extremity.

Based on the 2609 cases of flaps in 2512 patients from 1995 to 2004, the advantages and disadvantages of different sort of flaps, outcomes of treatment and indications of different soft of flaps were analyzed retrospectively. In the series, 2 089 pieces of the traditional flaps of different sorts were applied in 1992 patients, 474 pieces of the axial flaps of different sorts were applied in 474 patients, different sorts of free flaps were used in 46 patients.

Follow-ups were done for 1 month to 9 years (2.7 months in average). 2 531 flaps survived (97.01%); complete necrosis occurred in 10 flaps (0.38%); partial necrosis occurred in 68 flaps (2.61%). Of the 2089 traditional flaps, 46 had partial necrosis (2.2%); 687 needed flap revisions (32.9%). Of the 474 axial flaps, 28 had complete or partial necrosis (5.9%); 82 needed revisions (17.3%). Of the 46 free flaps, 4 had complete or partial necrosis (8.7%) and nearly all the anterolateral flaps of thighs needed revisions.

Traditional flaps had the advantages of easy manipulation and the highest survival rate, however, also had the disadvantages of poor texture and many times of operations. The flap with a pedicle had the advantage of good texture, consistent artery, free-range arc, however, the venous congestion was its disadvantage, which impaired the survival of the reverse flap. Free flap had the advantage of good texture and abundant donor site, but complicate manipulation was its shortage. Axial Flap with a pedicle is the optional choice for repairing soft tissue defects in upper extremity.