Anatomical Foundations and Clinical Utility of Personalized Free Ilioinguinal Zone Flap for Hand Skin and Soft Tissue Defect Reconstruction

Hui Zhang,1 Qiu-Jing Luo,2 Mao-Chao Ding,3 Jian-Wu Qi1 1Department of Hand Microsurgery and Plastic Reconstruction Center, Ningbo No.6 Hospital, Ningbo, 315040, People’s Republic of China; 2Department of Hand Surgery, Yuyao People’s Hospital, Ningbo, 315040, People’s Republic of China; 3Department of Human Anatomy, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, People’s Republic of ChinaCorrespondence: Jian-Wu Qi, Department of Hand Microsurgery and Plastic Reconstruction Center, Ningbo No.6 Hospital, No. 1059 of Zhongshan East Road, Yinzhou District, Ningbo, 315040, People’s Republic of China, Tel/Fax +86 18906627772, Email [email protected]: This study aims to explore the anatomical foundations and clinical utility of personalized free ilioinguinal zone flaps for reconstructing skin and soft tissue defects in the hand.Methods: Anatomical evaluations of the superficial circumflex iliac and the superficial epigastric arteries and veins were performed on 10 cadavers within the inguinal region. Forty-two patients received flap transplants from January 2017 to December 2022 to repair hand tissue defects. Flap areas ranged from 4.0 cm × 6.0 cm to 11.0 cm × 23.0 cm, with arterial anastomosis ensuring vascular connection to recipient sites. Donor sites were directly sutured for closure and healing.Results: The arteries, sourced from the femoral artery, were consistently identified in all cadavers, with a common trunk found in 70% of cases. Of the 42 transplants, 40 successfully survived, showing a high efficacy rate. Complications included two vascular crises; one was successfully managed, and one led to necrosis. Post-operative observations included soft flap texture, mild bloating, sensory recovery from S2 to S3, and minimal scarring at the donor site.Conclusion: The personalized free ilioinguinal zone flap is highly effective for repairing hand skin and soft tissue defects, offering advantages like direct donor site closure and reliable vascularity. This method shows great promise in enhancing outcomes in reconstructive hand surgery.Keywords: free, hand skin tissue defects, ilioinguinal flap, perforator flap, personalized