第一掌背动脉逆行岛状皮瓣移植修复示指软组织缺损  

Transplantation of Reverse Island Flap Pedicled with First Dorsal Metacarpal Artery for Soft Tissue Defect on Index Finger

作　　者：王凯夫[1] 唐树尧[1] 樊昌东[1] 

机构地区：[1]哈尔滨医科大学附属第一医院创伤外科,哈尔滨150001

出　　处：《中国现代手术学杂志》2008年第2期109-111,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨第一掌背动脉逆行岛状皮瓣修复示指皮肤缺损的效果。方法2000年6月-2007年6月采用第一掌背动脉逆行筋膜皮瓣修复示指皮肤缺损29例。该皮瓣以第一掌背动脉在第二掌骨背侧的纵轴为轴线,以筋膜为蒂,蒂部设计在皮瓣的远侧,供血动脉为示指桡侧指动脉。结果29例皮瓣全部成活,皮瓣面积为（2.0-3.0）cm×（1.5-3.0）cm。手术时间平均75（60-80）min。术中出血量平均35（25-40）ml。5例皮瓣出现静脉危象,2例出现张力性水疱,经拆除部分缝线及水疱穿刺抽吸后皮瓣颜色恢复红润。15例平均随访13.5（6-18）个月,皮瓣色泽红润,质地正常,外形佳,皮瓣两点辨别觉为5-7 mm,温、痛觉恢复良好,手指感觉运动功能均满意。结论切取第一掌背动脉逆行岛状筋膜皮瓣修复示指皮肤缺损安全可行,是修复示指皮肤较大面积缺损的理想方法。Objective To explore the effect of reverse fascial flap pedicled with first dorsal metacarpal artery for repairing the soft tissue defect on index finger. Methods From June 2000 to June 2007, 29 cases with skin defect on index finger were repaired by the first dorsal metacarpal artery reverse fascial flap. The line paralleled to vertical axial line of the dorsum of second metacarpus was served as central axis of the flap. The distal fascial pedicle was nurtured with radialis digital artery. Results All flaps were survived with the size of （2.0 - 3.0） cm × （ 1. 5 - 3.0） cm. The operative duration was 60 to 80 minutes （ average 75 ） ,. and the intraoperative blood loss was 25 -40 ml（ mean 35）. Venous crisis and tensive blisters was occurred in 5 and 2 flaps respectively, and were all recovered by some suture removing and needle puncture aspiration. 15 cases were followed up for 6 - 18 months （ mean 13.5 months ）. The flaps showed normal color, full elasticity and well appearance. The static two point discrimination was 5 to 7 mm. The digital pain and temperature sensation was recovered to normal and sensory and motor function of the injured fingers was satisfied. Conclusion The first dorsal metacarpal artery reverse fascial flap is safe, feasible and effective for repairing the soft tissue defect of index finger.

关 键 词：外科皮瓣 指损伤 

分 类 号：R658.2[医药卫生—外科学]