[Clinical study on abdominal expanded subdermal vascular plexus skin flaps for repairing dorsal hand scar]

To explore the method and effectiveness of abdominal expanded subdermal vascular plexus skin flaps in repairing dorsal hand scar.

Between May 2005 and October 2010, 16 cases of dorsal hand scars were treated with the abdominal expanded flaps. There were 13 males and 3 females, aged 22.5 years on average (range, 10-35 years). Defect was caused by burn in 10 cases, hot crush injury in 4 cases, and scald injury in 2 cases. The average scar formation was 21 months (range, 1 year and 6 months to 2 years). The patients had flexion restriction of metacarpophalangeal joint and interphalangeal joint. The scar size ranged from 11 cm x 7 cm to 18 cm x 10 cm. The expander was implanted in abdominal skin and inflated with water regularly at the first stage. After 2 weeks, the expanded pedicled flap was trasferred to repair wounds in which scars were excised. The flap size ranged from 12 cm x 9 cm to 19 cm x 12 cm. After being cut off the pedicle at 14 days, the fingers were divided, and the digital web was formed. The abdominal donor site was directly sutured.

All flaps survived. The wound and donor site achieved primary healing. Sixteen cases were followed up 1 year and 2 months to 3 years with an average of 2 years and 3 months. The flaps had soft texture and good flexibility. At last follow-up, hand function was graded as excellent in 13 cases, good in 2 cases, and poor in 1 case with an excellent and good rate of 93.7% according to the total active motion evaluation system.

Abdominal expanded subdermal vascular plexus skin flap is an effective method to repair large scar of the dorsal hand because it has satisfactory texture, fast rebuilding of blood supply, and large area of survival.