Ulnar artery-based supracarpal perforator flap in repairing soft tissue infection and defects of the wrist

Abulaiti Abula; Guliayixiamu Saimaiti; Cheng Erlin; Alimujiang Abulaiti; Ren Peng

doi:10.3969/j.issn.1009-4237.2025.09.006

Abstract：Objective To explore the clinical effect of the application of ulnar artery-based supracarpal perforator flap in the repair of skin or soft tissue defects in the wrist and palm.Methods A total of 17 patients with skin or soft-tissue defects surrounding the wrist or palm admitted to our hospital from Nov.2014 to Oct.2024 were retrospectively analysed,for whom ulnar artery-based perforator flap transplantation was conducted.There were 13 males and 4 females aged 29-62(mean 38.3)years,with 9 cases on the left and 8 on the right.Among them,9 ca-ses were open injuries of the wrist and palm,5 were palm space infections and 3 were electrical injuries.The wound defect area ranged from 8.0 cm×2.0 cm to 12.0 cm×5.0 cm.After debridement and expansion of the wound,the ul-nar artery-sourced perforator flap,sized 10.0 cm×3.0 cm to 15.0 cm×6.0 cm,was prepared for grafting.The donor-sites of the dorsoulnar forearm were directly sutured in 13 cases at one stage,and grafted in the other 4 cases.Pa-tients were followed-up regularly in the outpatient clinic to observe the survival of the skin flap,functional recovery,and healing of the donor site.Results All patients were followed up for 3 months to 7 years,3.7 years on average.Among the 17 cases,16 flaps survived completely;1 case with palmar space infection showed distal 1/3 partial nec-rosis;1 cases had postoperative haematoma,for which re-operation was conducted to clear the haematoma and postop-erative flap survival was achieved;2 cases had revision surgery at the second stage for bloated flap pedicle.Func-tional evaluation assessed by the upper limb part functiontrial criteria proposed by the Hand Surgery Society of Chi-nese Medical Association revealed excellent results in 12 cases,good in 4,and poor in 1,with the good-to-excellent rate being 94.1%.Conclusion The ulnar artery-derived perforator flap transplantation was effective in the repair of wrist and palm wounds.Most of the donor sites can heal without skin grafting(linear scar).