Free ilioinguinal flap transplantation in the treatment of hand soft tissue defect

Ma Gang; Guan Changhe; Wan Honglin; Zheng Xuegang; Wang Yongliang

doi:10.3969/j.issn.1009-4237.2025.03.010

Abstract：Objective To explore the effect of free ilioinguinal flap transplantation in the treatment of soft tissue defect of hand.Methods This retrospective analysis was conducted on 30 patients with hand soft tissue defects admitted to Deparatment of Orthopedics of Pangang Group General Hospital from Jan.2021 to Dec.2023,including 18 males and 12 females aged 36-62 Deparatment of Orthopedics(mean 50.4)years.Among them,13 patients combined with wound infection;7 cases were crushed by car accidents,14 by heavy objects,and 9 others;20 injured the back of the hand and 10 the palm.Soft tissue defects ranged from 4.0 cm×3.0 cm to 6.0 cm×8.0 cm.All patients received ilioinguinal flap for tissue defect reconstruction.The efficacy and safety of this technique were evaluated.The hand and upper limb functional recovery were assessed by the Disabilities of the Arm,Shoulder and Hand(DASH)scale,and the tentative criteria for upper limb function evaluation by the Society of Hand Surgery,Chinese Medical Association at 3,6 and 12 months after surgery.Results The flap survived in all the cases(100.0%).Patients were followed up for 12 months,which reported good appearance and soft texture of the skin flaps.After sur-gery,12 cases had significantly effective results and 18 effective results,and the effective rate of surgery was 100.0%.At 3,6 and 12 months after surgery,0,12 and 18 patients had DASH scores of 30-39;2,6 and 10 patients had DASH scores of 40-49;3,6 and 2 patients had DASH scores of 50-59;6,6 and 0 patients had DASH scores of 60-69;19,0,and 0 patients had DASH scores≥70,respectively.The DASH scores at 6 and 12 months were much lower than those at 3 months(P<0.05).At 3,6 and 12 months after surgery,the total score of the upper limb was 42.54±3.18,63.08±5.15 and 74.07±5.49,revealing significant differences between each time point(P<0.05).During the follow-up period,no vascular crises,skin shedding or dysfunction was reported.Conclusion Free ilioinguinal flap is effective and safe in the treatment of hand tissue defects,which is beneficial to the recovery of hand and upper limb functions.