指动脉背侧支皮瓣修复手指皮肤缺损的临床应用  

Clinical application of digital artery dorsal branch flap for coverage of soft tissue defect of the fingers

作　　者：周飞亚[1] 高伟阳[1] 宋永焕[1] 蒋良福[1] 杨景全[1] 丁健[1] 褚庭纲[1] 林丁盛[1] 

机构地区：[1]浙江省温州医学院附属第二医院骨科,325027

出　　处：《中华手外科杂志》2012年第6期350-351,共2页Chinese Journal of Hand Surgery

基　　金：温州市科技局重点项目基金（y20080082）

摘　　要：目的讨论以指动脉背侧支皮瓣修复手指皮肤缺损的方法及疗效。方法2010年5月至2011年10月，以指动脉背侧支皮瓣修复18例19指中末节皮肤缺损，均伴有肌腱或指骨外露。术中切取皮瓣面积为2．0cm×3．0cm-2．5cm×4．5cm，供区取前臂全厚皮片植皮修复。结果术后19指中16块皮瓣完全存活，3块皮瓣部分坏死。术后15例15指获得随访，3例失访；随访时间为6～12个月，术后患指外观、持物稳定性、关节活动功能等均较满意。15例皮瓣两点分辨觉为8—10mm，近、远指间关节屈伸活动基本正常。结论在熟悉该皮瓣的解剖学特点及仔细手术操作的前提下，指动脉背侧支皮瓣修复手指皮肤缺损是有效而简单的方法，并可获得良好的修复外形及功能。Objective To investigate and evaluate the results of covering soft tissue defect on the middle and distal segments of the fingers using digital artery dorsal branch flap. Methods From May 2010 to October 2011, 18 cases 19 fingers with soft tissue defects were treated with transferring the digital artery dorsal branch flap. The flap size ranged from 2.0 cm ×3.0 cm to 2.5 cm ×4.5 cm cm. The defect at the donor site was covered with full-thickness skin graft from the forearm. Results Sixteen flaps of 19 fingers survived. Partial necrosis occurred in 3 flaps. All the skin grafts at the donor sites survived. Fifteen cases of 15 fingers were follow-up for 6 to 12 months. The color, texture and contour of the flaps were good. Two-point discrimination was 8 to 10 mm. No obvious functional problem was found in PIP and DIP joint motion. Conclusion The digital artery dorsal branch flap is a good option for coverage of soft tissue defect of the finger. Familiarization with the anatomy and careful handling of the pivot point of the flap are key to ensuring survival of the flap and gaining good aesthetic and functional outcomes.

关 键 词：外科皮瓣 指损伤 治疗结果 

分 类 号：R658.2[医药卫生—外科学]