双翼皮瓣成形指蹼修复先天性并指畸形  

Reconstruction finger web with dorsal two wing-shaped flap for the treatment of congenital syndactyly

作　　者：田晓菲[1] 邱林[1] 傅跃先[1] 刘燕[1] 袁心刚[1] 肖军[1] 李天武[1] 

机构地区：[1]重庆医科大学附属儿童医院烧伤整形科,400014

出　　处：《中华整形外科杂志》2014年第2期96-98,共3页Chinese Journal of Plastic Surgery

摘　　要：目的 探讨应用双翼皮瓣成形指蹼修复先天性并指畸形的临床效果。方法对19例先天性并指畸形患儿，在并指根部背侧设计凸V形尖端、蒂部两侧带三角形皮肤的双翼皮瓣与掌侧锚形切口对应缝合，成形指蹼同时关闭指根部创面。并连的远端指体采用锯齿状皮瓣分离，侧方创面减脂后缝合，7例远端指体并连较紧、指侧方创面不能完全缝合者移植全厚皮片修复。结果所有病例指蹼及指根部均未植皮，7例指侧方所植全厚皮片均成活，创面均一期愈合。术后随访1～6个月，指蹼深度、宽度、坡度正常，瘢痕不明显。结论双翼皮瓣成形指蹼的同时，能关闭指蹼两侧创面，在指根部不需植皮，成形指蹼形态正常，是修复先天性并指畸形的较好方法。Objective To explore the clinical effect of using dorsal two wing-shaped flap to reconstruct finger web for treatment of congenital syndactyly. Methods This technique has been used in 19 children with congenital syndaetyly. At the dorsum, a flap with V-shaped tip and two wing-shaped pedicle were designed and was just sewed up with an anchor-shaped incision at the palm. The web was primarily reconstructed without skin graft at base of fingers. Distal end of fingers were separated by using serrated flap and were closed after removal of fatty tissue. At some cases with tight skin connection. The defect area at lateral and distal end of fingers was closed by small pieces of skin graft. Results All the webs were reconstructed primarily without skin graft at the base of fingers. 7 eases with tight skin connection had small pieces of skin graft at lateral and distal end of fingers. Primary healing was aehieved in all cases. After 1 to 6 months of follow-up, both the appearance and function were satisfactory without conspicuous scar. The reconstructed finger webs were in normal depth and width. Conclusions Primary web space can be achieved by dorsal two wing-shaped flap without skin graft at base of fingers. It is one of the best choices for treatment of congenital syndaetyly.

关 键 词：先天性并指 指蹼成形 

分 类 号：R726.5[医药卫生—儿科]