The Experience of the Free Superficial Palmar Branch of the Radial Artery Perforator flap Application

Abstract Purpose The purpose of this study is to retrospect and summarize clinical efficacy and experience of the free perforator flap base on the superficial palmar branch of the radial artery for tissue defect reconstruction in hand. Method 17 patients who underwent tissue defect in hands reconstruction by the free superficial palmar branch of the radial artery (SPBRA) perforator flaps in our department from July 2014 to October 2018 were reviewed. Results All the flaps in our series application were survival uneventful except one, which was necrosis because of venous thrombosis postoperative 5 days, and then the abdominal pedicle flap was executed to recover the defect in second stage. The first dorsal metacarpal artery flap and the arterial venous flap were utilized to cover the defect in one right index finger and one right ring finger due to the absence variation of the SPBRA. 2 cases presented tension vesicle of superficial skin and 1 case occurred venous congestion. All donor sites were closed primarily. The follow-up period means 13.5 months ( range, 4 ˜50 months). The static 2 point discrimination test mean 7.53 mm (range, 4 ˜ 11 mm). All flaps acquire protective feeling at the latest follow-up. The self-assessment of patients : 13 cases in good, 4 cases in fair. Conclusion The goal of physiological reconstruction and esthetic effect can be achieved for hand tissue defect by the free SPBRA perforator flap, multiple tissues of the flap can be contained according to the defect. Even though the SPBRA is variation, arterial venous flap could be applied thanks to abundant superficial cutaneous veins.