高度喫煙者に対する逆行性後骨間皮弁術においてdelay procedureを施行した1症例

抄録

Flap failure rates may be increased with the reversed artery flap, particularly among patients with risk factors such as advanced age, peripheral artery disease, venous insufficiency, diabetes mellitus, and smoking. This case report describes the use of a delay procedure to avoid flap necrosis in a potentially high-risk heavy smoker. A 70-year-old man sustained an injury to the right hand, resulting in the loss of a 6 cm × 7 cm area of skin and soft tissue from the first web. A reversed posterior interosseous artery flap was used. After elevating the flap, the proximal vascular pedicle was clamped. The pale elevated flap was then re-sutured to its original location. Three days later, the flap was re-elevated and clamped again at the proximal vascular pedicle. The ruddy-colored flap was rotated into the defect. The donor site was covered with grafted skin. The wound healed with no necrosis, and the patient returned to his previous work. This delay procedure appears useful as a treatment modality for patients with risk factors jeopardizing the reversed artery flap.