To explore the clinical effect of modified pedicled thoracoumbilicus flap in repairing destructive injury wounds of hands.

A total of 18 patients with destructive injury wounds of hands treated in Department of Burns of Plastic Surgery, the 910th Hospital of Joint Logistics Support Force of PLA from October 2017 to July 2021 were selected as the research objects. The patients were divided into single-procedure group (containing 14 patients) and two-procedure group (containing 4 patients). The single-procedure group were treated with modified thoracic umbilical cord flap to cover the wounds after the basal boundary of wound debridement was clear. The two-procedure group was treated with wound debridement at the first stage, to remove necrotic tissue and retain para-ecological tendonous tissue. After 5-7 days of vacuum sealing drainage, the wound base was clean with the exposed tendon and bone. The wound was covered with modified thoracicumbilical flap in the second stage. For all the 18 patients, the pedicled flaps were cut off 10 to 14 days after the operation, and 4 patients with syndactyly underwent pedicle division and syndactyly division. The survival of skin flap, operation times, wound healing time, hand function and scar were observed.

The pedicled thoracoumbilical flaps of all the 18 patients are survived after pedicle breakage with 12 patients′ wounds healing after two operations and 6 patients′ wounds healing after three operations. The wound healing time was 18-27 days, with an average of (23.4±2.1) days. The hospital stay was 20-30 days, with an average of (24.6±2.3) days. During the follow-up of 8 to 12 months, the flaps of hand had soft texture, warm skin, mild scar, and no obvious bloated appearance. The scar of the donor site was mild. And, the appearance and function of the recipient site was recovered well. The vancouver scar scale score of the recipient site was 1.2-3.5 points. There were only 2 obese female patients were admitted to the hospital for flap thinning surgery in 6 months later after discharge.

For destructive injury wounds of hands, the use of modified thoracoumbilical flap for repair and reconstruction can restore the function of the hand well. With the simple operation, the modified thoracoumbilical flap is worthy of clinical promotion and application.