吻合血管的骨间背穿支皮瓣修复手指皮肤缺损  

Free posterior interosseous dorsal perforator flap for soft-tissue coverage of the finger

作　　者：吴攀峰[1] 唐举玉[2] 李康华[2] 刘鸣江[1] 肖湘君[1] 黄雄杰[1] 陈彦名[1] 王郑钢[1] 

机构地区：[1]湖南省衡阳市南华大学附属南华医院手外科,421001 [2]中南大学湘雅医院骨科

出　　处：《中华手外科杂志》2012年第6期361-363,共3页Chinese Journal of Hand Surgery

摘　　要：目的介绍吻合血管的骨间背穿支皮瓣修复手指皮肤缺损的临床方法和经验。方法2006年5月至2011年5月对29例手指皮肤软组织缺损患者行术前彩色B超定位，术中采用不携带深筋膜的骨间背穿支皮瓣进行修复，吻合骨间背动脉与指固有动脉、皮下浅静脉与指背静脉，并可吻合骨间背静脉及手指掌侧静脉。结果术后27例皮瓣存活，随访6—12个月，皮瓣质地优良，外观比较满意；2例皮瓣出现静脉危象，1例完全坏死，1例部分表皮坏死。结论吻合血管的骨间背穿支皮瓣是一种修复手指皮肤缺损的较好方法。Objective To introduce the clinical experience and surgical methods of soft-tissue coverage of the finger using a free posterior interosseous dorsal perforator flap. Methods From May 2006 to May 2011, 29 cases of soft tissue defects of the finger were treated. The posterior interosseous dorsal perforator was located by color Dopplar ultrasound preoperatively for flap design. The deep fascia was not included during flap harvesting. The posterior interesseous dorsal artery was anastomosed to the proper digital artery, while the subcutaneous vein in the flap was anastomosed to the dorsal vein of the finger. Alternatively the dorsal interosseous vein was anastomosed to the finger palmar subcutaneous vein. The cosmetic appearance of the donor and recipient sites were evaluated in a follow-up visit. Results Twenty-seven flaps survived uneventfully. Venous crisis occurred in 2 flaps, one of which had complete necrosis and the other had partial epidermal necrosis. After 6 to 12 months＇ postoperative follow-up, all patients achieved a cosmetically acceptable result. Conclusion It is a good method to repair skin defect of the finger using a free posterior interosseous dorsal perforator flap without including the deep fascia. Because of the added advantage of reducing donor-site morbidity, posterior interosseous perforator flaps have become the authors＇ preferred option in reconstructive cases of the finger.

关 键 词：外科皮瓣 指损伤 骨间背侧血管 

分 类 号：R658.2[医药卫生—外科学]