Repair of hand scars by a dilated deep inferior epigastric artery perforator flap

Abstract

We have investigated the mapping of several deep inferior epigastric artery perforator (DIEAP) vessels in each patient, the effect of tissue expansion on the variation in the diameter of the DIEAP vessel, and the clinical effect of repair of hand scars by applying a dilated DIEAP flap. From 2000 to 2009, we did some research on this flap using a Doppler probe and computed tomographic (CT) angiography, and found that the inferior epigastric arteries are distributed between 4 cm above the umbilicus and 8 cm below the umbilicus. Most of the vessels are distributed in zones I, II, and III according to the Rand zonal approach. The arteries were rarely found in zone IV, and there was a relatively dense distribution of perforators in the nearby umbilical plane. Most of the biggest perforators were located in the peripheral umbilicus, and the mean (SD) diameter of perforator vessels was increased by 33% (8)% after expansion. The dilated DIEAP flap was used to treat 18 cases of hand scars. After the operation, 16 flaps survived; the two that did not, had slight blood flow defects in the distal portion of the flap, and the overall effects of the treatment were good. After the DIEAP flaps had been expanded for a long time, blood supply and the area of the flap are increased. The flap generated by this method is thin, has good resistance, and a nice appearance, and is therefor a better method for treating wounds of the hand and arm, and claw hand.

Key Words::

• Tissue expansion
• deep inferior epigastric artery perforator
• CTA
• scar

Acknowledgements

We thank attending physician Dr. Bing Liu from the First Affiliated Hospital of Anhui Medical University for assistance with the CT angiography, data processing, and three-dimensional reconstruction.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.