Transplanting Free Descending Genicular Artery Perforator Flap for Vessel Flow-Through in Linking with other Free Flaps

Introduction: We performed this retrospective study to analyze our strategies for treating the multi-tissue defect in hand with transplanting free descending Genicular Artery pedicle perforator flap for vessel flow-through in linking other free flaps.

Methodology and Material: Seven patients with multi-defects in hand underwent surgery at our institution, from Jan.2008 to Jan.2013. Five patients were male and Two were female (age range, 27 to 35 years; mean, 29.4 years). Four of the patients had penetrating injuries, three had blunt trauma injuries. Six cases were the multi-defect in palm and finger area, Five of these surgically treating were free descending Genicular Artery (DGA) perforator flap linked with great toe fibular flap and one of the surgically treating was free DGA perforator flap connected with second toe tibial side pulp flap. One case was defected both in dorsal and volar of hand area, which treated by free DGA perforator flap united lateral upper arm flap. The area of these DGA perforator flap was 6-8cm×9-12cm and the length of DGA pedicle was 4cm-7cm.

Results: All of these united flow-through perforator flaps were survived. Follow-up 6-12 months showed that the appearance and texture of the flaps were good and the flaps sensory recovery partially.

Conclusions: We believe that good results can be achieved in patients with multi-defect in hand by use of free DGA flap for vessel flow-through. The DGA perforator flap linked with other flaps can repair the multi-defect areas in one time, which could decrease the time of operation and save the main vessel of the donor site. We believe that free flow-through DGA perforator flap can link with other free flap, which is an effective surgical.