To explore the clinical efficacy of modified abdominal pedicled flap in repairing severe burn and trauma wounds of the hand.

From August 2020 to October 2024， 43 patients with severe hand burn and trauma injuries admitted to the Department of Burns and Plastic Surgery of the 910th Hospital of Joint Service Support Unit of PLA were divided into observation group （22 cases） and control group （21 cases） based on different wound repair methods. The observation group was treated with modified abdominal pedicled flaps， including the design of individualized thin flaps， reservation of silk threads in the pedicle and interdigital areas， and early pedicle division and finger separation after staged and segmented ligation to block local blood supply post-operation. If the donor site could not be sutured， auxiliary flaps or autografts were used for repair， and vacuum sealing drainage （VSD） dressings were applied to both donor and recipient sites. The control group was treated with traditional abdominal pedicled flaps， large fat particles at the distal end of the flap were removed, and the flap was transferd to cover the wound， pedicle division was performed at 3 weeks post-operation， followed by finger separation and flap revision at a later stage. Donor sites were sutured or grafted， and recipient and donor sites were dressed with sterile gauze. The pedicle division time， flap survival rate at 7 days after pedicle division， wound healing time and number of operations were compared between the two groups. At the last follow-up, two-point discrimination， patient satisfaction， and the excellent and good rate of hand function recovery were compared between the two groups. Data were analyzed using t-test， χ² test， Fisher's exact test， and Mann-Whitney U test.

The flap pedicle division time of the observation group was earlier than that of the control group ［（10.43±1.38） d vs. （21.29±1.06） d， t=28.755， P<0.001］. The flap survival rate at 7 days after pedicle division in the observation group was higher than that in the control group ［100.0% （100.0%， 100.0%） vs. 100.0% （96.5%， 100.0%）， Z=2.050， P=0.032］. Compared to the control group, the wound healing time was shorter ［（16.71±1.45） d vs. （37.33±4.55） d， t=19.755， P<0.001］， and the number of operations was fewer ［2 （2， 2） vs. 3 （2， 3）， Z=3.025， P=0.002］ in the observation group. At the last follow up， the two-point discrimination of the flap in the observation group showed no statistically significant difference compared to the control group ［（7.46±2.48） mm vs. （8.33±2.56） mm， t=1.100， P=0.277］. The satisfaction rate with flap appearance was 90.9%， the satisfaction rate with donor site appearance was 86.4%， and the excellent and good rate of hand function was 95.5% in the observation group， while those were 61.9%， 57.1%， and 71.4% in the control group， respectively. The differences between the two groups were statistically significant （χ²=5.064， 4.560， 4.551， P<0.05）.

Compared to the traditional abdominal pedicled flaps， the modified abdominal pedicled flaps for repairing severe hand burn and trauma wounds allows for earlier pedicle division and simultaneous finger separation. After division， the flap exhibits a higher survival rate， shorter wound healing time， fewer surgical procedures， unaffected flap sensation， and greater patient satisfaction with the appearance of both donor and recipient sites， along with better hand function recovery.