急诊多种皮瓣修复近节指背软组织缺损  

Emergency repair of dorsal soft tissue loss at the proximal phalanx level by four kinds of flaps

作　　者：李世民[1] 周艳玲[1] 余业文[1] 石惠文[1] 陈康察[1] 周健辉[1] 林戈亮[1] 王夫平[1] 

机构地区：[1]中山市小榄人民医院手外科,广东528425

出　　处：《中华手外科杂志》2006年第2期83-84,共2页Chinese Journal of Hand Surgery

摘　　要：目的报道采用多种皮瓣急诊修复近节指背软组织缺损的临床效果。方法采用邻指筋膜瓣、邻指掌指背筋膜血管神经蒂皮瓣、远位真皮下血管网皮瓣、掌背皮瓣等4种方法,对28例近节指背软组织缺损进行急诊修复。结果28例皮瓣全部存活。术后随访2～24个月,平均10个月。所有皮瓣色泽、质地、弹性均良好,皮瓣无挛缩。邻指筋膜瓣优良率为85．7%、邻指掌指背筋膜血管神经蒂皮瓣优良率为90%、远位真皮下血管网皮瓣优良率为85．7%、掌背皮瓣优良率为100%。邻指掌指背筋膜血管神经蒂皮瓣,术后感觉恢复接近健指,其余3种皮瓣感觉均明显减低。结论急诊修复近节指背软组织缺损首选邻指掌指背筋膜血管神经蒂皮瓣,其次为掌背皮瓣、邻指筋膜瓣或远位真皮下血管网皮瓣。Objective To report the treatment outcome of emergency repair of dorsal soft tissue loss at the proximal phalanx level by four kinds of flaps. Methods 28 cases of dorsal soft tissue loss at the proximal phalanx level were repaired by 4 kinds of flaps： cross-finger fascial flap, dorsal metacarpophalangeal island flap from the neighbouring finger padicled with fascia, vessel and nerve, remote flap with subdermal vascular plexus, and dorsal metacarpal island flap. Results All 28 flaps survived. Over a period of 2 - 24 months＇ follow-up （average 10 months）, the shape, elasticity, and texture of the flaps were found to be satisfactory. There was no contracture of the flaps. The satisfactory rates of the above-mentioned flaps were 85.7%, 90%, 85.7%, and 100% respectively. Sensation was near normal only in the pedicled dorsal metacarpophalangeal island flap. Reduced sensation was noticed in the other 3 types of flaps. Conclusion The dorsal metacarpophalangeal island flap from the neighbouring finger pedicled with fascia, vessel and nerve was the first choice for emergency repair of dorsal soft tissue loss at the proximal phalanx level. The other 3 types of flaps can also be alternatively applied.

关 键 词：外科皮瓣 指损伤 显微外科手术 治疗结果 

分 类 号：R658.2[医药卫生—外科学]