Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Oct 2:26:49-53.
doi: 10.1016/j.jpra.2020.09.005. eCollection 2020 Dec.

Sequential chimeric free deep circumflex iliac artery bone flap and superficial circumflex iliac artery perforator flap from the same site for one-stage reconstructions of severe hand injury: A report of two cases

Taiichi Matsumoto  1 , Takuya Tsumura  1 , Katsuma Kishimoto  1 , Hirokazu Sano  1 , Kohei Doi  1 , Mutsumi Matsushita  1 , Hiroshi Murakami  1
Affiliations
Case Reports

Sequential chimeric free deep circumflex iliac artery bone flap and superficial circumflex iliac artery perforator flap from the same site for one-stage reconstructions of severe hand injury: A report of two cases

Taiichi Matsumoto et al. JPRAS Open. .

Abstract

Two flaps, namely the free vascularized iliac bone graft supplied by the deep circumflex iliac artery (DCIA) and the superficial circumflex iliac artery perforator flap supplied by the superficial circumflex iliac artery (SCIA), can be individually harvested from a single surgical field. We report two cases treated by these free flaps for severe hand injury with large skin defect and osteomyelitis. Sequential chimeric flaps were anastomosed between the ascending branch of the DCIA and the SCIA. The advantage of this method is more freedom in the flap insetting for complex tissue defects. For this reason, this method is also excellent for cosmetic appearance. Furthermore, donor site morbidity can be minimized because the flaps are harvested from the same site.

Keywords: Bone loss; Complex tissue defects; Osteomyelitis; Skin defect coverage; Superficial circumflex iliac artery; Vascularized iliac bone graft.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Case 1 was a 34-year-old female. The patient had osteomyelitis of her carpal bone and a large skin defect (upper left). The chimeric one-pedicle-artery flap consisting of the SCIP flap (13 × 9 cm) and the FVIBG (3.5 × 2 cm) were harvested from the same field (right). Black arrowhead indicates the arterial anastomosis site. LFCN, lateral femoral cutaneous nerve; FVIBG, free vascularized iliac bone graft.
Figure 2
Figure 2
Case 2 was a 41-year-old male. This patient presented with severe trauma of the skin, bones, nerves, and vessels as a result of a degloving injury (left column). The proximal phalanx and skin around the thumb necrosed (middle column). ✽ indicates where the ulnar digital artery of thumb was reconstructed with a vein graft. The chimeric one-pedicle-artery flap consisting of the SCIP flap (10 × 5 cm) and the FVIBG (3.5 × 1.5 cm) were harvested from the same field (right column). We harvested this FVIBG supplied by the perforator from main trunk of the DCIA. DCIA, deep circumflex iliac artery; FVIBG, free vascularized iliac bone graft.
Figure 3
Figure 3
Case 2. We performed end-to-side anastomosis of the radial artery and the DCIA, and end-to-end anastomosis between the ascending branch of the DCIA and the SCIA. Two-stage extensor tendon reconstruction using a silicone rod and sheet (right column). DCIA, deep circumflex iliac artery; FVIBG, free vascularized iliac bone graft.
See this image and copyright information in PMC

References

    1. Koshima I., Nanba Y., Tsutsui T. Superficial circumflex iliac artery perforator flap for reconstruction of limb defects. Last Reconstr Surg. 2004;113(1):233–240. - PubMed
    1. Strauch B, Yu HL, editors. Vol. 143. Thieme; New York: 2006. Atlas of microvascular surgery. (Anatomy and Operative Techniques).
    1. Bishop A., Shin A. Vascularized bone grafting, iliac crest. In: Wolfe S, Pederson W, Hotchkiss R, Kozin S, editors. 6th ed. Vol. 1782. Churchill Livingstone; Philadelphia: 2010. (Green's Operative Hand Surgery).
    1. Bitter K., Danai T. The iliac bone or osteocutaneous transplant pedicled to the deep circumflex iliac artery. I. Anatomical and technical considerations. J Maxillofac Surg. 1983;11(5):195–200. - PubMed
    1. Salibian A.H., Anzel S.H., Salyer W.A. Transfer of vascularized grafts of iliac bone to the extremities. J Bone Joint Surg Am. 1987;69(9):1319–1327. - PubMed

Publication types

LinkOut - more resources