Application and efficacy of manual fat granule extrusion for thinning bulky flaps in hand and foot reconstruction
CHEN Chao
HAN Quan
WANG Zengtao
LIU Yang
LIU Xiangrun
WANG Yaxing
Abstract：Objective To observe the application effectiveness of manual extrusion of fat granules for thinning bulky flaps(subcutaneous fat thickness≥2 cm)in hand and foot reconstruction,providing a safe and effective method for prima-ry flap thinning during reconstruction.Methods Fourteen patients undergoing free flap transplantation for hand and foot reconstruction were included.Intraoperatively,the harvested free flaps all had a subcutaneous fat thickness≥2 cm and were subjected to primary thinning using the manual fat granule extrusion method.The specific procedures:first,the free flap was harvested on the deep fascia,followed by radial incisions in the superficial fascia around the perforators;then,ei-ther before or after pedicle division,the flap was manually squeezed to extrude fat granules,thinning the flap to a subcuta-neous fat thickness≤0.5 cm.The time required for the flap thinning procedure,the subcutaneous fat thickness after thin-ning,intraoperative intractable vascular spasm,as well as vascular crisis and skin ecchymosis within 7 days postopera-tively were observed and recorded.Flap survival was followed up in the outpatient clinic within 1 month postoperatively.Results In all 14 patients,thinning of the bulky flap was completed within 20 minutes.After thinning,the subcutane-ous fat thickness was≤0.5 cm in all cases,and no major vascular branches were sacrificed during the manual extrusion of fat granules.No cases of intractable vascular spasm occurred intraoperatively.Within 7 days postoperatively,there were no complications such as vascular crisis,partial necrosis,or ecchymosis.At the 1-month follow-up,all flaps survived.Conclusion In the hand and foot reconstruction,the manual extrusion of fat granules for thinning bulky flaps is a safe and effective method for primary flap thinning.
Keywords：manual fat granule extrusionflapflap thinningprimary flap thinningfree flap transplantationhand and foot reconstruction
Publication Date：2026-01-25
Online Publishing Date：2026-03-05(First online date of this platform, not the publication date of the document)
Pages：5( 118-121,131 )