近节掌指背皮瓣修复指根部岛状皮瓣供区的临床应用  

Clinical application of dorsal proximal phalangeal flap for covering donor site defect of reverse digital artery island flap

作　　者：周晓[1] 芮永军[1] 寿奎水[1] 许亚军[1] 姚群[1] 

机构地区：[1]无锡市手外科医院手外科,214062

出　　处：《中华手外科杂志》2012年第4期221-223,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨应用近节掌指背皮瓣修复指动脉逆行岛状皮瓣供区的手术方法。方法对15例指端缺损的患指，应用指根部岛状皮瓣进行修复，同时应用近节掌指背皮瓣修复岛状皮瓣的供区。结果术后30块皮瓣全部存活，随访时间5个月至2年，皮瓣外观及弹性好，患指无疼痛；岛状皮瓣静止两点分辨觉为7—8mm，掌指背皮瓣静止两点分辨觉为8～10mm。手功能按中华医学会手外科学会上肢部分功能评定试用标准评定：优13，良2例。皮瓣供区指蹼的大小、深度无影响，皮瓣修复后指蹼无瘢痕挛缩、外形隐蔽；指蹼最大外展达30°-40°，与健侧指蹼外展相似。结论该术式操作简单，术后疗效满意，是对传统指根部岛状皮瓣供区修复方法的改进。Objective To introduce the surgical techniques of repairing donor site defect of reverse digital artery island flap by perforator flap from the dorsum of the proximal phalanx. Methods Fifteen cases with skin defects of the fingertips were treated with reverse digital artery island flap transfer. Defects at the donor site were repaired with perforator flap from the dorsum of the proximal phalanx. Restdts All 30 flaps survived in 15 cases. The patients were follow-up for 5 months to 2 years. The appearance and the texture of the flaps were good. The fingers were pain free. Two-point discrimination was 7 to 8 mm for the island flaps and 8 to 10 mm for the perforator flaps. According to the hand function evaluation criteria issued by the Chinese Hand Society, the hand function was graded as excellent in 13 cases and good in 2 cases. There were no obvious complications of the donor sites. The width and depth of the web space were ：not affected. There was no web contracture and finger abduction reached 30~ to 40~, close to normal. Conclusion This procedure is easy and effective. The trealinent result is satisfactory. It is an improvement over conventional donor site defect repairing techniques in reverse digital artery island flap transfer.

关 键 词：指损伤 外科皮瓣 缺损 

分 类 号：R658.2[医药卫生—外科学]