指动脉逆行岛状皮瓣的临床应用  

Clinical application of reverse digital artery island flap

作　　者：陈建生[1] 方建根[1] 王星华[1] 

机构地区：[1]木渎人民医院骨科,苏州215101

出　　处：《中华手外科杂志》2007年第4期229-230,共2页Chinese Journal of Hand Surgery

摘　　要：目的通过对280例指动脉逆行岛状皮瓣修复手指缺损的临床分析,探讨本术式修复手指缺损的临床疗效。方法 1999年12月—2005年6月,对280例手部不同指别、不同部位的皮肤缺损患者,采用指动脉逆行岛状皮瓣进行修复,术后对其疗效进行随访分析。结果术后280例皮瓣全部存活,其中5例皮瓣于术后48 h内出现静脉回流障碍,经拆除部分缝线、换药后愈合。术后随访1～2年,其中27例皮瓣出现不同程度的并发症,如皮瓣臃肿、瘢痕挛缩、怕冷、冻疮、供区瘢痕触痛、麻木等。280例中,95例为指腹缺损而行皮瓣内神经与指背神经缝合,术后皮瓣感觉恢复满意,两点分辨觉为5～9 mm,外形较未缝合神经的皮瓣饱满。结论指动脉逆行岛状瓣修复手指缺损不失为一种较好的方法,但要正确选择适应证,注意术后并发症的预防。Objective To evaluate the effect of using reverse digital artery island flap in patients with skin defects on different digits. Methods From December 1999 to June 2005, 280 patients with skin defects in different parts of the digits were treated with reverse digital artery island flap transfer. The patients were followed up for 1 to 2 years and the outcomes were analyzed. Results All these flaps survived. In 5 cases, venous congestion emerged within 48 hours of the surgery. After partial stitch removal and dressing change, these flaps healed. Various complications were seen in 27 cases, including bulky flap, scar contracture, cold intolerance, tenderness at donor site, numbness and so on. In 95 cases, the nerve of the flaps was sutured with dorsal branch of digital nerves. Recovery of sensation of the flaps was satisfactory. 2-point discrimination of the resurfaced pulp was 5 to 9 mm. The appearance of the flap was also better. Conclusion Reverse digital artery island flap is a good option for coverage of skin defects of the digits. Care should be taken to select the right indications and prevent complications.

关 键 词：指损伤 外科皮瓣 手术后并发症 

分 类 号：R658.2[医药卫生—外科学]