甲皮瓣游离移植的血循环危象  

CIRCULATORY CRISIS IN FREE GRAFTING OF THE WRAP AROUND FLAP WITH NAIL FROM THE BIG TOE

作　　者：侯明钟[1] 贾万新[1] 袁启智[1] 黄燮青[1] 缪勇[1] 腾可颖[1] 

机构地区：[1]上海市第一人民医院整形外科

出　　处：《中华显微外科杂志》1997年第1期7-10,共4页Chinese Journal of Microsurgery

摘　　要：目的：了解甲皮瓣游离移植发生血循环危象的机理，并与第２足趾移植的危象相比较。方法：通过１００例皮瓣血循环危象病例之分析，探讨第１跖背动脉（ＦＤＭＡ）行径、手术操作、动脉顽固性痉挛、静脉硬化及术后探查时间等因素对皮瓣存活的影响，并进行统计学分析。结果：甲皮瓣移植发生血循环危象的机遇比第２足趾移植的多，主要由于手术损伤所致，并存在独特的再造手指顶端甲床坏死与皮瓣边缘张力缝合坏死并发症。结论：甲皮瓣与第２足趾游离移植发生血循环危象的规律相似，但甲皮瓣的手术损伤更多。皮瓣宽松缝合，创缘间隙内植皮，可以防止移植指顶端及皮瓣血供障碍。Objective:To study the mechanism of circulatory crisis in free grafting flap from the big toe as compare with that from the free transfer of the second toe Methods:100 cases of circulatory crisis were statistically analysed Influential factors in the vitality of flap were as follow as:anatomical distribution of the FDMA the type of the wrap around flap,the operating maneuver,the persistent arterial spasm or the venosclerosis and the explorative time in critical cases after operation Results:The circulatory crisis from fhe big toe flap was more than that from the free transfer of the second toe It mainly occurs in the flaps of surgical trauma of vascularity. There was a pathognomonic necrosis in the nailbed and on the edge of flap because of tense suture Conclusion:The mechanism of circulatory crisis of wrap around flap grafting and second toe free transfer in similer but the surgical trauma in wrap around flap grafting is more serious The necrosis in reconstructive finger tip and on the flap edge can be prevented by loose suturing of flap or shin grafting

关 键 词：MU甲皮瓣 血循环 危象 第1跖背动脉 

分 类 号：R658[医药卫生—外科学] R622.1[医药卫生—临床医学]