指背筋膜蒂皮瓣在手指皮肤缺损修复中的应用  

The clinical efficacy of ringer soft tissue defect reparation with fasciocutaneous flap of dorsal branch of digital arteary

作　　者：杨杰[1] 于晓洁[1] 王鹏[1] 王建成[1] 曹文宏[1] 许会敏[1] 

机构地区：[1]廊坊市人民医院手显微外科,065000

出　　处：《疑难病杂志》2014年第1期65-66,69,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨指背筋膜蒂皮瓣修复手指皮肤缺损的临床疗效。方法 2011年10月—2013年2月收治手指皮肤及软组织缺损患者33例(37指),男19例(22指),女14例(15指);受伤至入院时间1h^15d;指腹皮肤缺损17指,甲床缺损9指,中节掌侧皮肤缺损6指,中远节掌侧皮肤缺损5指;皮瓣切取而积0.8cm×1.0cmy^1.9 cm×2.7 cm,应用大小为1.0cm×1.2 cm^2.1cm×2.9cm的指背筋膜蒂皮瓣修复创而,供区游离植皮修复。根据患指缺损形状、大小、在指背设计皮瓣,自手指近端游离皮瓣,远端设计为"泪滴"状。皮瓣与受区疏松缝合,放置引流片,供区近节指背采用全厚皮片植皮修复。术后抗炎抗痉挛等常规治疗。结果术后5例皮瓣远端出现张力性水疱,经换药后愈合;其余皮瓣及供区植皮均顺利成活,创面均Ⅰ期愈合。术后30例(34指)获随访,随访时间6~25个月,中位数16.8个月。皮瓣质地柔软,外观饱满。术后6个月皮瓣两点辨别觉为6~9 mm,中位数7.7 mm。手功能按手指总主动活动度评分法评定达105°~230°,中位数204.6°。结论指背筋膜蒂皮瓣修复手指皮肤缺损创伤小,手术操作简单,可以早期功能锻炼;术后皮瓣厚薄、质地良好,皮瓣可恢复感觉,是一种修复手指皮肤缺损的好方法。Objective To explore the clinical efficacy of dorsal fasciocutaneous flap in reparation of finger skin defeet.Methods From October 2011 to February 2013,admitted finger skin and soft tissue defects were 33 cases（37 ringers）,19 males（22 fingers）and 14 females（15 fingers）;injury to admission time 1h-15 d;pulp skin defects in 17 ringers,the nail bed defect in 9 fingers,middle section of palmar skin defects in 6 fingers,middle and distal section of the palmar skin defects in 5 fingers;flaps cut area 0.8 cm×1.0 cm-1.9 cm×2.7 cm.Application size is.0cm×1.2 cm-2.1 cm×2.9 cm of the dorsal fasciocutaneous flap wounds,donor skin graft repair.According risk fingers to the defect shape,size and design of the dorsal flap,free flap from the finger proximal,distal design for the ＂teardrop＂ shape.Loose flap and suture subject area,place the drainage sheet for proximal dorsal area with full thickness skin graft repair.Postoperative inflammatory anti-spasmodic and other conventional treatment.Results Five cases of distal flap tension blisters appear after operation,healed after changing dressing;other flaps and skin graft donor sites were successfully survived,the wounds acquired grade I healing.30 cases（34 fingers）were followed up for 6 to 25 months,median 16.8 months.Flap soft,plump appearance.6 months after operation flap point discrimination was 6-9 mm,median 7.7 mm.Hand function by finger total active activity score were assessed up to 105°-230°,median was 204.6°.Conclusion Dorsal fasciocutaneous flap repair the skin defect finger trauma is a simple operation,which can be performed with early exercise;flap thickness were thinner with good texture,flap restore the feeling,which is a good approach for finger skin defect repairing.

关 键 词：手指软组织缺损 指背筋膜蒂皮瓣 创面修复 

分 类 号：R658.2[医药卫生—外科学]