Comparison of perforator flap and abdominal pedicled flap in the treatm ent of skin and soft tissue defect by hand traum a

Objective To investigate the clinical effect of perforator flap and abdominal pedicled flap in patients with skin and soft tissue defect resulting from hand trauma, and to explore the advantages, disadvantages and indications of the two treatment. Methods There were 42 patients suffering from skin and soft tissue defects by hand trauma from June 2017 to June 2019 in People's Hospital of Wugang. The patients were divided into two groups according to the selection of different flaps, group A(abdominal pedicled flap, n=21) and group B(perforator flap, n=21). The wound healing time, postoperative complications and functional recovery were compared between the two groups. Results All patients were followed up for 3 to 16 months, with an average of 6.8 months. The excellent and good rate in the group B(100.0%) was significantly higher than that in the group A(66.7%, χ²=6.171, P=0.013). The healing time in the group B(18.4±1.2) days was significantly shorter than that in the group A(35.9±1.4) days(t=42.895, P<0.001). The incidence of postoperative complications such as infection and flap necrosis in the group B was 4.8%, which was significantly lower than that in the group A(52.4%, χ²=11.667, P<0.001). The postoperative function was evaluated by the evaluation standard of upper limb function of hand surgery Association of Chinese Medical Association. The passing rate of functional recovery in the group A was 66.7%, and that in the group B was 95.2%(χ²=5.559, P=0.018). Conclusion Compared with the abdominal pedicled flap, perforator flap is more effective in repairing skin and soft tissue defects in hand followed by the shorter healing time and less complications, which is worthy of recommendation. However, abdominal pedicled flap can be regarded as an alternative when microsurgical technique has not been developed in some primary hospitals.