Flow-through ulnar artery proximal perforator flaps for wound coverage of palm defects

Objective To investigate the clinical application of flow-through ulnar artery proximal perforator flaps for wound coverage of palm defects.Methods From February 2012 to October 2012,flowthrough ulnar artery proximal perforator flap was used to treat 5 cases of traumatic skin and soft tissue defects of the palm along with metacarpal artery injury and compromised finger perfusion.The vessel of the flap was inset between the ends of the injured metacarpal artery to repair the metacarpal artery so both the flap and the fingers were perfused.Postoperatively patency of the vessel was monitored by ultrasound.Patients' satsfaction of flap aesthetics was assessed by a questionnaire.Pain,touch and temperature sensations,two-point discrimination and finger movement were tested.Results All five flaps survived well.The patients were follow-up for 12 to 18 months.The flaps were thin and had good appearance.The flow through vessel was patent in all the cases.Primary healing was achieved in the donor sites.The patients were highly satisfied with the appearance of the flap (100％).Perception of pain,temperature and touch was restored at 6 months postoperatively,while two-point discrimination returned to 7.3 to 12.lmm at 12 months,with an average of 7.8 mm.S3+ sensation was restored to the flaps.Conclusion Flow-through ulnar artery proximal perforator flaps are suitable for repairing some special wound defects with artery injuries by not only reconstructing skin defects of the palm,but also restoring blood circulation to the fingers. Key words: Ulnar artery;  Finger injuries;  Perforator;  Flow-through flaps