改良指掌侧横行岛状皮瓣修复指端缺损  

Repair of fingertip defect with improved transverse palmar island flap

作　　者：钱俊[1] 芮永军[1] 张全荣[1] 吴权[1] 吴柯[1] 

机构地区：[1]无锡市第九人民医院、无锡市手外科医院,江苏省无锡市214062

出　　处：《中华显微外科杂志》2014年第3期219-221,共3页Chinese Journal of Microsurgery

摘　　要：目的介绍应用改良指掌侧横行岛状皮瓣修复指端缺损的手术方法和疗效。方法从2011年1月至2013年2月，采用缺损创面近端指掌侧横行岛状皮瓣修复指端皮肤软组织缺损15例17指。皮瓣以一侧血管神经束为蒂，切取后旋转90。覆盖创面。缺损面积：1．2cm×0．8cm～1．7cm×1．6cm。患者受伤入院时间为40min-27h，平均入院时间6．5h。5例为急诊修复，10例为亚急诊修复。随访时手指功能根据中华医学会手外科学会断指再植功能评定试用标准评定。结果15例17指术后创口Ⅰ期愈合，皮瓣均顺利成活。13例获随访，时间6～14个月。13例15块岛状皮瓣血液循环良好，手指外形良好。皮瓣两点辨别觉为6—11mm，平均8．4mm。根据中华医学会手外科学会断指再植功能评定试用标准评定：优11例，良2例。结论改良指掌侧横行岛状皮瓣适合于修复指端横形缺损及小面积指腹皮肤缺损患者，该术式具有手术简便、供区不用植皮、术后手指外形及手功能恢复满意等优点。Objective To introduce the technique and treatment outcome of the fingertip soft tissue defect with improved transverse palmar island flap. Methods From January 2011 to February 2013, 15 cases（ 17 fingers） fingertip defect were repaired by improved transverse palmar island flap, the vascular pedicled of flap was a side of the neurovascular bundle, the flap revolved 90% to coversoft tissue defect. Defect area： 1.2 cm Ⅰ0. 8 cm to 1.7 cm Ⅰ1.6 cm. The time between the injury and admission was 40 minutes to 27 hours. Five cases were repaired defection with flap immediately, 10 cases were repaired defection in stage 11. Results The wounds of injury in 15 cases get primary healing, and all the flaps were successfully survived. The 13 cases were followed up for 6 months to 14 months. The blood circulation of flap was fine, and the fingertip shape as well. The two point discrimination of the skin pulp was 6 mm to 11 mm. Conclusion The improved transverse palmar island flap for repairing transverse finger pulp defect and a small area of skin defect in patients. The procedure has a simple surgery, donor area don＇t skin graft, postoperative appearance and hand finger satisfactory functional recovery, etc.

关 键 词：指端缺损 指腹 岛状皮瓣 显微外科手术 

分 类 号：R658.2[医药卫生—外科学]