gms | German Medical Science

Objectives/Interrogation: The purpose of this study was to report the feasibility of free vascularized multi-lobed groin flap transfers for hand coverage or for donor sites coverage after finger reconstruction.

Methods: From January 2018 to July 2018, 5 cases suffered multiple soft tissue defects on hand were reconstructed using multi-lobed groin flaps. One patient had skin defects on dorsal hand and proximal area of dorsal skin on index to little fingers, and was reconstructed using a free groin flap with randomized separating distal part of flap into 4 lobes to cover dorsal fingers. The second patient had dorsal hand defect from dorsal wrist extended to middle phalange of index to little finger, which was reconstructed using two lobed groin flaps, so that the four lobes could cover 4 injured fingers individually. The arteries of two groin flap were anastomosed to two ends of a Y-shape vein graft, which was end-to-side anastomosed to radial artery. The third patient had dorsal skin defect on index to little fingers, and was reconstructed using a 4-lobed groin flap based on the superficial circumflex iliac artery and superficial inferior epigastric artery. The arteries were anastomosed to radial arteries through a Y-shape vein graft. These three patients had a large size of dorsal hand soft tissue defects in the hand and in several fingers. Multi-lobed groin flaps based on superficial branch and deep branch were used to cover the donor site defects after finger reconstruction in another two cases.

Results and Conclusions: All the flaps survived except a small size of marginal area necrosis in the case with dorsal skin reconstruction of four fingers. The small wound healed without surgical intention. The repaired fingers generally had acceptable cosmetics and pinch function of these fingers are also acceptable. The sensation of these fingers generally were less than ideal.

Free vascularized multi-lobed groin flaps are a useful method for multiple soft tissue defects on hand and fingers. The flap is reliable and cosmetics and pinch function after transfer to the hand is acceptable. However, the sensory recovery of the reconstructed fingers is still a concern after extensive trauma and flap coverage.