指背神经营养血管皮瓣的临床应用  

Clinical Application of Dorsal Digital Neurovascular Flap

作　　者：程学锋[1] 李锦永[1] 胡洪良 王换新[1] 

机构地区：[1]郑州市第二人民医院骨科,450006 [2]河南省漯河市第二人民医院显微外科

出　　处：《医学研究杂志》2013年第10期131-133,共3页Journal of Medical Research

摘　　要：目的探讨指背神经营养血管皮瓣的临床疗效及手术技巧。方法 2008年5月~2012年5月,收治手指皮肤缺损患者29例,缺皮创面为2.6cm×1.5cm^1.2cm×1.0cm,均采用指背神经营养血管皮瓣予以修复。皮瓣切取较实际创面宽松0.5~0.8cm,供区中厚皮片移植,打包加压。结果术后27例完全成活,创面Ⅰ期愈合,供区植皮均成活,切口Ⅰ期愈合;2例皮瓣远端部分坏死,经换药愈合。23例得到8~26个月的随访,平均16个月。末次随访时,21例修复指背创面者,皮瓣外观满意,颜色正常、质地柔软、无皴裂、耐摩擦,功能恢复良好;2例修复掌侧创面者,外观稍欠丰满,功能恢复良好。结论手指小面积缺皮创面,采用指背神经营养血管皮瓣修复,可取得较好疗效。Objective To investigate the therapeutic effects and surgical techniques of dorsal digital neurovascular flap. Methods A total of 29 patients with fingers skin defects （2.6cm x 1.5cm - 1.2cm x 1.0cm） were admitted to our hospital from May 2008 to May 2012. All these skin defects were reconstructed with dorsal digital neuro - vascular flaps. The width of the flap was broader than wound surface by 0.5 - 0.8cm. The donor sites were covered with mid - thickness skin grafts and dressed with a pressure pack. Results Twen- ty - seven dorsal digital neurovascular flaps survived completely after operation, accompanied with first intention healing wound, survived skin grafts in donor sites and first intention healing incisions. Necrosis was observed in the distal partial of 2 dorsal digital neurovascular flaps, which was healed after changes of dressing. 8 - 26 months follow - up was performed in 23 cases. Average of which was 16 months. By the end of follow -up period, 21 cases obtained satisfactory appearance, normal color, natural soft tissue, no chap and anti -friction bearing. In all, the function of the flaps was reserved. The appearance of 2 palmar skin defect cases was lack of fullness, whereas the function was retained. Conclusion Small area of skin defects in fingers and thumbs can be reconstructed with dorsal digital neurovascular flap. The therapeutic effect will be satisfying.

关 键 词：手指 皮肤缺损 指背神经 外科皮瓣 显微外科 

分 类 号：R622.1[医药卫生—整形外科]