改良顺行指动脉推进皮瓣修复指端软组织缺损的临床效果  

Clinical effects of modified anterograde homodigital neurovascular island flap for repairing soft tissue defects in the distal part of the finger

作　　者：秦宏玖 马涛 Qin Hongjiu;Ma Tao(Department of Hand and Foot Surgery,the First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)

机构地区：[1]皖南医学院第一附属医院手足外科,芜湖241000

出　　处：《中华整形外科杂志》2022年第12期1340-1343,共4页Chinese Journal of Plastic Surgery

基　　金：安徽高校自然科学研究重点项目(KJ2021A0822)

摘　　要：目的探讨改良顺行指动脉推进皮瓣修复指端软组织缺损的临床效果。方法回顾性分析2019年9月至2021年6月皖南医学院第一附属医院手足外科收治的指端软组织缺损患者的临床资料,均采用双V-Y设计的改良顺行指动脉推进皮瓣修复指端创面,观察术后皮瓣成活及切口愈合情况,随访记录皮瓣两点辨距觉,并采用中华医学会手外科学会上肢部分功能评定试用标准评价手功能。结果共纳入患者15例,男12例,女3例;年龄26~67岁,平均46岁;均为单指的指端软组织缺损,损伤指别:拇指7例,示指4例,中指2例,环指1例,小指1例;指端缺损面积为1.0 cm×1.0 cm~1.3 cm×1.4 cm。术后15例皮瓣全部成活,切口愈合良好。随访时间6~12个月,平均8.9个月。末次随访时患指皮瓣两点辨距觉为4~6 mm,平均5.1 mm。手功能评价:优9例,良6例。结论改良顺行指动脉推进皮瓣血供可靠、推进距离长、感觉恢复满意,是小面积指端缺损的有效修复方式。Objective To explore the clinical effects of modified anterograde homodigital neurovascular island flap for repairing soft tissue defects in the distal part of the finger.Methods The data of patients with fingertip defects in the Department of Hand and Foot Surgery,the First Affiliated Hospital of Wannan Medical College from September 2019 to June 2021 were analyzed retrospectively.All the patients were treated with double V-Y designed modified anterograde homodigital neurovascular island flaps.The survival of these flaps and wound healing were observed after operation.At the last follow-up,sensibility of the flap was assessed.Hand function was evaluated according to the upper limb function evaluation standard of the Chinese Society of Hand Surgery.Results The patients comprised 12 males and 3 females with an average age of 46 years(26-67 years).Single-finger defects were noted in all cases.The injured included 7 thumbs,4 index fingers,2 middle fingers,1 ring finger,and 1 little finger.The area of wound defect was 1.0 cm×1.0 cm-1.3 cm×1.4 cm.All flaps survived in 15 cases and the wounds healed well.All cases were followed up 6-12 months(mean,8.9 months).At last follow-up visited,the discrimination distance between the two points was 4-6 mm(mean,5.1 mm),and the hand function was excellent in 9 cases and good in 6 cases.Conclusions The modified anterograde homodigital neurovascular island flap has reliable blood supply,long advance distance and satisfactory sensation recovery,which is an effective method for reconstructing small-size finger tip defects.

关 键 词：指损伤 软组织缺损 指动脉 皮瓣 

分 类 号：R622[医药卫生—整形外科]