两种皮瓣在皮肤缺损型断指再植修复中的应用  

The application of two types of flaps in replantation of severed fingers accompanied with skin defect

作　　者：侯桥[1] 曾林如 王利祥[1] 许良[1] 吴国明[1] 吴档[1] 

机构地区：[1]浙江省杭州市萧山区中医院手外科,311200

出　　处：《中华手外科杂志》2012年第5期267-269,共3页Chinese Journal of Hand Surgery

摘　　要：目的总结邻指指动脉岛状皮瓣及静脉血营养的静脉皮瓣在皮肤缺损型断指再植修复中的临床效果。方法对15例15指皮肤缺损型断指（皮肤缺损位于手指背侧、掌侧及环形），分别采用邻指指动脉岛状皮瓣修复4例，静脉血营养的静脉皮瓣修复9例，邻指指动脉岛状皮瓣联合静脉血营养的静脉皮瓣修复2例。结果15例断指及其皮瓣全部存活，其中有2例指体术后发生血管危象，行手术探查后断指及皮瓣存活。术后随访1-18个月，平均7个月，再植指体无明显短缩，皮瓣质地良好、不臃肿，再植指体外观及功能恢复满意。结论邻指指动脉岛状皮瓣及静脉血营养的静脉皮瓣是修复皮肤缺损型断指再植的有效手术方法。Objective To summarize the clinical effects of adjacent finger digital artery island flap and venous blood nutrient flap in the replantation of severed fingers accompanied with skin defects. Methods Fifteen fingers in 15 patients accompanied with dorsal, volar or circumferential skin defects were replanted. The skin defects were covered with digital artery island flap for the adjacent finger in 4 cases, venous blood nutrient flap in 9 cases, and with adjacent finger digital artery island flap combined venous blood nutrient flap in 2 cases. Results All 15 replanted fingers and the flaps survived completely. Postoperative vascular crisis occurred in 2 fingers, which was resolved by surgical exploration and intervention. The fingers and flaps were rescued. The patients were follow-up for 1 to 18 months, with an average of 7 months after the replantation. The replanted fingers had no significant shortening. The flaps had good texture and were not bulky. The appearance and function of the replanted fingers were satisfactory. Conduslon The adjacent finger digital artery island flap and venous blood nutrient flap are effective methods to cover skin defects in replantation of severed fingers.

关 键 词：外科皮瓣 指损伤 再植术 

分 类 号：R658.2[医药卫生—外科学]