Related factors and prevention of pigmentation in cutaneous neurovascular flap / 中华医学美学美容杂志

ABSTRACT

Objective:To explore the risk factors of skin flap pigmentation after repairing skin and soft tissue defects of extremities using cutaneous neurovascular flap and to give some suggestions for prevention and treatment.Methods:From January 2013 to March 2020, 160 cases of extremities cutaneous nerve vascular flap with survival in Tangshan Second Hospital were retrospectively studied. According to the occurrence of pigmentation, they were divided into two groups Group A (pigmentation group) and Group B (non-pigmentation group). The observation indexes included sex, age, injury cause, defect size, complete debridement, anastomosis of skin flap, sunscreen measures and postoperative infection. First, univariate analysis was carried out to screen the influencing factors of pigmentation in the cutaneous neurovascular flap, and then Logistic regression was used for multivariate analysis to screen the risk factors.Results:The postoperative follow-up time was 12 to 24 months, with an average of 17.9 months. A total of 29 patients (18.1%) had skin flap pigmentation. Univariate analysis showed that there was no significant difference in sex, age, cause of injury and defect area between the two groups ( P>0.05). Further multivariate analysis showed that incomplete debridement, lack of venous anastomosis, failure to take sunscreen measures and postoperative infection were the risk factors of pigmentation of cutaneous neurovascular flap ( OR=0.310, 0.335, 0.355、5.878, 95% CI=0.112-0.863, 0.115-0.975, 0.133-0.949, 2.069-16.697, P<0.05). Conclusions:Incomplete debridement, lack of venous anastomosis, failure to take sunscreen measures and postoperative infection are the risk factors resulting in pigmentation of neurovascular flap. It is important to perform prevention to reduce the incidence of pigmentation.