同指顺行指动脉岛状皮瓣修复指端缺损  

Repair of digit tip defect by using anterograde digital artery island flap from the same finger

作　　者：董玉金[1] 童致虹[1] 杨卫东[1] 曾伟峰[1] 

机构地区：[1]大连市中心医院手足外科,辽宁大连116033

出　　处：《实用手外科杂志》2012年第1期10-12,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨同指顺行指动脉岛状皮瓣修复指端缺损的临床疗效。方法本组46例指端缺损患者，创面清创后急诊行顺行指固有动脉岛状皮瓣移位修复手指指端缺损。缺损范围为1．0cm×1．0cm×2．0cm×2．5cm。皮瓣设计于同指中远节掌侧桡侧半或尺侧半，以创缘为横轴，纵轴与所携带血管神经蒂平行，近端未超过中节指横纹，皮瓣两侧缘均不过中线。结果46例皮瓣全部成活，无静脉回流障碍，供区创面一期愈合，术后随访3～12个月，皮瓣外形满意、质地柔软、弹性好、色泽与正常接近，皮瓣不臃肿能耐寒，伤指无疼痛。两点辨别觉达6-10mm。手功能按综合评定法评定：优28指，良16指．可2指，优良率96％。结论同指顺行指动脉岛状皮瓣移位修复指端缺损，皮瓣供区靠近创面，手术方法简便，术后功能及外形满意，是治疗指端缺损的一种比较理想的术式。Objective To explore the curative effect of using anterograde digital artery island flap from the same finger to repair digit tip defect. Methods 46 cases of the digit tip defect were treated with anterograde digital artery island flap from the same finger after the wound surface cleaned immediately. The defect scopes were 1.0cm×l.0cm to 2.0cmX2.Scm.The skin flaps were designed on wound edge in the distal or middle section of the same finger, which longitudinal axis was the radial or ulnaris neurovascular bundle, proximal end didn＇t exceed the middle finger crease,and two sides didn＇t exceed the midline of dorsal and palmaris.The size of flaps were 1.0cm×1.0cm to 2.0cm×2.Scm. Results All the 46 transferred flaps survived completely. Postoperative following-up ranged from 3 to 12 months, the flaps had good appearance and texture. No patients complained about pain or cold intolerance. The mean static two-point discrimination was 6mm to 10ram. According to the TAM standard, the results were excellent in 28 cases, good in 16, fair in 2, with 96% overall excellent and good rate. Conclusion It is an ideal method for reconstruction of digit tip defect by using anterograde digital artery island flap from the same fingers, with its simple technique, satisfactory result.

关 键 词：顺行岛状皮瓣 手指指端缺损 修复 

分 类 号：R658.1[医药卫生—外科学]